Individual provider Active NPI

Maryann Kane, ED.D.

  • Exercise & Sports Psychologist
  • Exeter, NH
National Provider Identifier
1508074493
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exercise & Sports PsychologistTaxonomy code 103TE1100X
License
709 Issued in NH
Practice address
163 Water St
Exeter, NH 03833-2424
Phone
(603) 580-5920
Fax
(603) 778-0022
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 709 NH
Exercise & Sports Psychologist 103TE1100X 709 NH Primary

Addresses

Primary practice location

163 Water St
Exeter, NH 03833-2424

Mailing address

163 Water St
Exeter, NH 03833-2424
Phone (603) 580-5920

Other identifiers 1

IdentifierTypeStateIssuer
30424962MedicaidNH

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Exeter Counseling Center, PLLC Clinical PastSince Mar 1, 2013 Accepting new patients

Organizations & group practices 1

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1508074493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 WATER ST",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038332424",
            "telephone_number": "603-580-5920",
            "fax_number": "603-778-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 WATER ST",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038332424",
            "telephone_number": "603-580-5920",
            "fax_number": "603-778-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE",
        "first_name": "MARYANN",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "709",
            "primary": false
        },
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "NH",
            "license": "709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30424962",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Exeter, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.