Individual provider Active NPI

Michelle Patrice Mackenzie, MS, RDN, CDN

  • Obesity and Weight Management Nutrition Registered Dietitian
  • Wallingford, CT
National Provider Identifier
1336071851
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X
License
000407 Issued in CT
Practice address
219 Parker Farms Rd
Wallingford, CT 06492-2858
Phone
(203) 631-1146
NPI assigned
Jun 1, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 000407 CT
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X 000407 CT Primary

Addresses

Primary practice location

219 Parker Farms Rd
Wallingford, CT 06492-2858

Mailing address

219 Parker Farms Rd
Wallingford, CT 06492-2858
Phone (203) 631-1146

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
000407CTMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1780272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1336071851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 PARKER FARMS RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922858",
            "telephone_number": "203-631-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 PARKER FARMS RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922858",
            "telephone_number": "203-631-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "MICHELLE",
        "middle_name": "PATRICE",
        "credential": "MS, RDN, CDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-01",
        "last_updated": "2026-06-01",
        "certification_date": "2026-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CT",
            "license": "000407",
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "CT",
            "license": "000407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.