Mary Grady, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD25177 Issued in ME

Practice address

2 Portland SQ Ste 201
Portland, ME 04101-4088

Phone

(207) 607-4022

Fax

(207) 613-5048

NPI assigned

Mar 23, 2018

Last updated

Nov 21, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 17, 2023 through Nov 17, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Psychology Specialists of Maine

  • Counseling Psychologist
  • Brunswick, ME
  • NPI 1326571241
  NPD (past)

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1316442262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MAINE ST STE 309",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112033",
            "telephone_number": "207-607-4022",
            "fax_number": "207-613-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PORTLAND SQ STE 201",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014088",
            "telephone_number": "207-607-4022",
            "fax_number": "207-613-5048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADY",
        "first_name": "MARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-23",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "MD25177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avery Ruth Grace, LMSW-CC
• Graceful Care LLC
• Kristin Leigh Tetz Graczyk, APRN
• Stephanie L Gradone, DPT
• Ruth Grady-Carver, LCSW
• Cassandra Graham, LCSW
• Corrin Graham, RN
• Julia Graham, LCPC
• Lindy E Graham, LCSW
• Sarah Graham

• Psychiatry Physician in Portland, ME
• Providers in Portland, ME by specialty
• Psychiatry Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.