Mary M. Kenan, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

30875 Issued in TX

Practice address

2500 E T C Jester Blvd Ste 238
Houston, TX 77008-1449

Phone

(713) 826-1587

NPI assigned

Oct 17, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mary M. Kenan Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Baylor College of Medicine

  • Ph.D. Medical Genetics
  • Houston, TX
  • NPI 1881026664
  Medicare reassignment Care Compare group NPD
• Baylor College of Medicine

  • Orthopaedic Surgery Physician
  • Sugar Land, TX
  • NPI 1700683844
  NPD
• Baylor College of Medicine

  • Ophthalmology Physician
  • Houston, TX
  • NPI 1457423949
  NPD (past)
• Baylor College of Medicine

  • Neurology Physician
  • Houston, TX
  • NPI 1881624666
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1881774149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 CAMBRIDGE ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304202",
            "telephone_number": "713-798-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E T C JESTER BLVD STE 238",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081449",
            "telephone_number": "713-826-1587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1914 W Gray St",
            "address_2": "#302",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770194884",
            "country_code": "US",
            "telephone_number": "713-826-1587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENAN",
        "first_name": "MARY",
        "middle_name": "M.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "30875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040983101",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkenan1711@bcm.ghhdirect.net",
            "affiliation": "N",
            "address_1": "7200 Cambridge St Fl 9",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770304202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "KENAN",
            "middle_name": "M.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Emily Kemper, LCSW, LCDC
• William Craig Kemper
• Ana J. Kempfer, RN, CNS
• Jessica Kempka, CPNP-AC
• Kempwood Dental, PLLC
• Deborah Diane Kendall, PT
• Deconda Kendall
• Kendred Wellness Center, PLLC
• Danesha Danay Kendrick
• James Barton Kendrick II, M.D.

• Psychologist in Houston, TX
• Providers in Houston, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.