Maia Lucy Penchansky, PCA, RD, LD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

R8799 Issued in OR

Practice address

1110 SE Alder St Ste 300
Portland, OR 97214-2400

Phone

(503) 404-3637

NPI assigned

Sep 8, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• MP Nutrition Therapy LLC

  • Registered Dietitian
  • Salem, OR
  • NPI 1396357265

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1536364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1548743354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 SE ALDER ST STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142400",
            "telephone_number": "503-404-3637",
            "fax_number": "503-974-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 SE ALDER ST STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142400",
            "telephone_number": "503-404-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENCHANSKY",
        "first_name": "MAIA",
        "middle_name": "LUCY",
        "credential": "PCA, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-08",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-10193411",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R8799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Pena
• Stephanie Rojo Pena, RN
• Felicitas Amelia Penaloza
• Alexandra Penaluna
• Jennifer Morgan Penberthy, MA
• Bradley Royce Pendergraft, LCSW
• Paul Pendergraft, AU.D.
• Melissa Pendergrass, M.D.
• Tyson Pendery
• Julie Anne Pendleton, N.D.

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.