Individual provider Active NPI

Mara Ivanka Galic, MHSC, RD

  • Registered Dietitian
  • Mableton, GA
National Provider Identifier
1013897552
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
930413 Issued in GA
Practice address
5332 Vinings Lake VW SW
Mableton, GA 30126-2542
Phone
(404) 441-4029
NPI assigned
Sep 4, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 930413 GA Primary

Addresses

Primary practice location

5332 Vinings Lake VW SW
Mableton, GA 30126-2542

Mailing address

5332 Vinings Lake VW SW
Mableton, GA 30126-2542
Phone (404) 441-4029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
930413GAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1013897552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5332 VININGS LAKE VW SW",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301262542",
            "telephone_number": "404-441-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5332 VININGS LAKE VW SW",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301262542",
            "telephone_number": "404-441-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALIC",
        "first_name": "MARA",
        "middle_name": "IVANKA",
        "credential": "MHSC, RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "930413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mableton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.