Individual provider Active NPI

Ekaterina Mahinda, PSY.D.

  • Clinical Neuropsychologist
  • Sacramento, CA
National Provider Identifier
1336458132
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
35126 Issued in CA
Practice address
1535 River Park Dr Ste 1000
Sacramento, CA 95815-4601
Phone
(916) 734-6700
NPI assigned
Sep 28, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 35126 CA Primary

Addresses

Primary practice location

1535 River Park Dr Ste 1000
Sacramento, CA 95815-4601

Mailing address

1535 River Park Dr Ste 1000
Sacramento, CA 95815-4601
Phone (916) 734-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241120002477 CA Practitioner - Clinical Psychologist 2062947542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 8022922475, 562 clinicians

Practice addresses (Care Compare)

1535 River Park Dr
Sacramento, CA 95815-4601

4860 Y St
Sacramento, CA 95817-2307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35126CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Oct 15, 2024 Accepting new patients
Regents of the University of California CurrentSince Oct 15, 2024 Accepting new patients

Locations

10850 White Rock Rd
Rancho Cordova, CA 95670

1535 River Park Dr
Ste 1000
Sacramento, CA 95815
Phone (916) 286-1000

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

1535 River Park Dr
Ste 2000
Sacramento, CA 95815
Phone (916) 286-1010

Organizations & group practices 2

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": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1336458132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 RIVER PARK DR STE 1000",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154601",
            "telephone_number": "916-734-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 RIVER PARK DR STE 1000",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154601",
            "telephone_number": "916-734-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHINDA",
        "first_name": "EKATERINA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "35126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.