Active NPI
Mackenzie Marie Canterbury, DO
- Diagnostic Radiology Physician
- Sacramento, CA
National Provider Identifier
1013520352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- PTL4384
- Practice address
- 3161 L St
Sacramento, CA 95816-5234 - Phone
- (916) 878-3495
- NPI assigned
- Aug 26, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | PTL4384 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
3161 L St
Sacramento, CA 95816-5234
Mailing address
PO Box 255228
Sacramento, CA 95865-5228
Other practice location 1
1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 781-9000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 255228
Sacramento, CA 95865
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Sutter Roseville Medical Center
- General Acute Care Hospital
- Roseville, CA
- NPI 1356390264
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783468800000",
"number": "1013520352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 255228",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958655228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3161 L ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958165234",
"telephone_number": "916-878-3495"
}
],
"practiceLocations": [
{
"address_1": "1 Medical Plaza Dr",
"address_purpose": "LOCATION",
"city": "Roseville",
"state": "CA",
"postal_code": "956613037",
"country_code": "US",
"telephone_number": "916-781-9000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CANTERBURY",
"first_name": "MACKENZIE",
"middle_name": "MARIE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-26",
"last_updated": "2026-07-08",
"certification_date": "2026-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "PTL4384",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.