Mind Shift Wellness Clinic LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

MIND SHIFT WELLNESS CLINIC LLC

Practice address

31 Granite St Ste 2
Milford, MA 01757-1695

Phone

(508) 933-1804

NPI assigned

Mar 26, 2026

Organization subpart

No

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

Authorized official

Name

Kenneth Mutegyeki, PMHNP-BCNPI 1487410999

Title

Director

Phone

(508) 306-1128

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth Mutegyeki, RN BSN

  • Nurse Practitioner
  • Milford, MA
  • NPI 1487410999
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1774483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774483200000",
    "number": "1063351815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 GRANITE ST STE 2",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571695",
            "telephone_number": "508-306-1128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 GRANITE ST STE 2",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571695",
            "telephone_number": "508-933-1804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND SHIFT WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-26",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A",
        "authorized_official_last_name": "MUTEGYEKI",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "508-306-1128",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Miller
• Jillian Miller
• Jillian Miller
• Lauren Evelyn Miller, RD, LDN
• Ashleigh Mills
• Penni Dyan Mindes, EDUCATOR
• Mint Condition Physical Therapy
• Yesica C Miranda Pinto
• Melissa Ann Miranda
• Raven Miranda

• Nurse Practitioner in Milford, MA
• Providers in Milford, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.