Individual provider Active NPI

Jacquelyn Mainelli, RD

  • Sports Dietetics Nutrition Registered Dietitian
  • Phoenix, AZ
National Provider Identifier
1083524342
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Dietetics Nutrition Registered DietitianTaxonomy code 133VN1501X
Practice address
3805 N 53Rd Ave
Phoenix, AZ 85031-3046
Phone
(623) 245-5500
NPI assigned
Sep 9, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Dietetics Nutrition Registered Dietitian 133VN1501X Primary

Addresses

Primary practice location

3805 N 53Rd Ave
Phoenix, AZ 85031-3046

Mailing address

30 W Spring St
Alexandria, VA 22301-2451

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1788912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1083524342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W SPRING ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223012451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 N 53RD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850313046",
            "telephone_number": "623-245-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAINELLI",
        "first_name": "JACQUELYN",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-09",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.