Individual provider Active NPI

Kendra Jo Kisner, MS, RDN, LRD

  • Registered Dietitian
  • Fargo, ND
National Provider Identifier
1376408104
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1693 Issued in ND
Practice address
1717 University Dr S
Fargo, ND 58103-4939
Phone
(701) 234-4111
NPI assigned
Dec 23, 2025
Last updated
Dec 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1693 ND Primary

Addresses

Primary practice location

1717 University Dr S
Fargo, ND 58103-4939

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260108004093 ND Practitioner - Registered Dietitian Or Nutrition Professional 9537645510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 5074
Sioux Falls, SD 57117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1693NDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Jan 1, 2026 Accepting new patients
Sanford Medical Center Fargo Current Accepting new patients
Sanford Medical Center Fargo CurrentSince Jan 1, 2026 Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients
Sanford Medical Center Fargo Past Accepting new patients

Locations

1717 University Dr S
Fargo, ND 58103
Phone (701) 234-2305

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1766448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1376408104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034939",
            "telephone_number": "701-234-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISNER",
        "first_name": "KENDRA",
        "middle_name": "JO",
        "credential": "MS, RDN, LRD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-23",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ND",
            "license": "1693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.