Individual provider Active NPI

Mary M Machulda, PHD

  • Clinical Psychologist
  • Rochester, MN
National Provider Identifier
1801874011
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP4245 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
NPI assigned
Jan 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP4245 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other identifiers 1

IdentifierTypeStateIssuer
918192000MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100319000021 MN Practitioner - Clinical Psychologist 5597890236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LP4245MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic CurrentSince May 1, 2001 Accepting new patients
Mayo Clinic CurrentSince May 1, 2001 Accepting new patients
Mayo Clinic Current Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Organizations & group practices 3

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": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1801874011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHULDA",
        "first_name": "MARY",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-06",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "918192000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.