Individual provider Active NPI

Mackenzie Nicole Mueller, MS, RD, LD

  • Registered Dietitian
  • Bethesda, MD
National Provider Identifier
1700415833
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT85823 Issued in TX
Practice address
4701 Sangamore Rd Ste N100
Bethesda, MD 20816-2558
Phone
(914) 919-9200
NPI assigned
Apr 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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 DT85823 TX Primary

Addresses

Primary practice location

4701 Sangamore Rd Ste N100
Bethesda, MD 20816-2558

Mailing address

5414 Northdale Dr
Austin, TX 78723-6214
Phone (972) 375-4369

Other practice location 1

911 W 38th St
Austin, TX 78705-1188
Phone (512) 459-1131

Other practice location 2

4625 Lindell Blvd Fl 2
Saint Louis, MO 63108-3739
Phone (914) 919-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220202000759 TX Practitioner - Registered Dietitian Or Nutrition Professional 8325431075 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nourish, Inc. Dietitian, Registered CurrentSince Jul 1, 2023 Accepting new patients

Locations

500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000

3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039

Interoperability endpoints

  • Direct secure messaging: mackenzie.mueller.1@25307.direct.athenahealth.com

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": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1700415833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5414 NORTHDALE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787236214",
            "telephone_number": "972-375-4369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 SANGAMORE RD STE N100",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208162558",
            "telephone_number": "914-919-9200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "911 W 38th St",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787051188",
            "country_code": "US",
            "telephone_number": "512-459-1131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4625 Lindell Blvd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631083739",
            "country_code": "US",
            "telephone_number": "914-919-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "MACKENZIE",
        "middle_name": "NICOLE",
        "credential": "MS, RD, LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT85823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.