Rory Tolentino Pettigrew, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY35642 Issued in CA

Practice address

877 Mahler Rd Ste 160
Burlingame, CA 94010-1640

Phone

(650) 822-1057

NPI assigned

Aug 22, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Rory Tolentino Pettigrew Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 22, 2026 through Feb 22, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Banyan Psychology Inc.

  • Clinical Psychologist
  • Burlingame, CA
  • NPI 1386336501
  NPD

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

{
    "created_epoch": "1598054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748044800000",
    "number": "1336751072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 EL CAMINO REAL STE 120",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 MAHLER RD STE 160",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940101640",
            "telephone_number": "650-822-1057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLENTINO PETTIGREW",
        "first_name": "RORY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-22",
        "last_updated": "2025-05-24",
        "certification_date": "2025-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY35642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RORY",
            "last_name": "TOLENTINO PETTIGREW",
            "credential": "PSY.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christina Yuxin Tian
• Tib Diagnostics LLC
• Tina H. Yoo, D.D.S., M.S., Inc.
• Michael Antonio Titus Jr.
• TK Svensson MD & S Morrow MD Inc
• Caroline S Tonetti, PH.D.
• Karen Tong, DPT
• Lana Xian Tong, M.D., M.P.H.
• Topmed Transport
• Topnk Home Medical Care LLC

• Clinical Psychologist in Burlingame, CA
• Providers in Burlingame, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2025; 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.