Individual provider Active NPI

Katelyn Rose McMahan, MD

  • Psychiatry Physician
  • Corvallis, OR
National Provider Identifier
1942883541
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD214923 Issued in OR
Practice address
3600 NW Samaritan Dr
Corvallis, OR 97330-3737
Phone
(541) 768-4906
NPI assigned
Apr 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD214923 OR Primary
Psychiatry Physician 2084P0800X PG205135 OR

Addresses

Primary practice location

3600 NW Samaritan Dr
Corvallis, OR 97330-3737

Mailing address

3600 NW Samaritan Dr
Corvallis, OR 97330-3737

Other practice location 1

3333 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-2185

Other names 1

  • Katelyn Rose Ruark Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210719001827 OR Order and Referring Only - PsychiatryPractitioner - Psychiatry 5698178390

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of North Dakota School of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1115 SE 164TH Ave Dept
Suite 358
Vancouver, WA 98683-8004

3333 Riverbend Dr
Springfield, OR 97477-8800

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1942883541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 NW SAMARITAN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 NW SAMARITAN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303737",
            "telephone_number": "541-768-4906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Riverbend Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974778800",
            "country_code": "US",
            "telephone_number": "541-222-2185",
            "fax_number": "541-222-2194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMAHAN",
        "first_name": "KATELYN",
        "middle_name": "ROSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-30",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD214923",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "PG205135",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "RUARK",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.