Individual provider Active NPI

Maria Elaine Kennedy, MPH, RD, LDN

  • Registered Dietitian
  • Cary, NC
National Provider Identifier
1952642175
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
L004141 Issued in NC
Practice address
401 Keisler Dr Ste 101
Cary, NC 27518
Phone
(919) 524-6551
Fax
(844) 364-9280
NPI assigned
Mar 13, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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 L004141 NC Primary

Addresses

Primary practice location

401 Keisler Dr Ste 101
Cary, NC 27518

Mailing address

401 Keisler Dr Ste 101
Cary, NC 27518-7084
Phone (919) 524-6551

Other practice location 1

401 Keisler Dr Ste 101
Cary, NC 27518
Phone (919) 524-6551

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200505003181 NC Practitioner - Registered Dietitian Or Nutrition Professional 1557792694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nutrition and Diabetes Counseling Center of NC LLCGroup PAC ID 1052715984, 2 clinicians

Practice addresses (Care Compare)

527 Keisler Dr
Suite 101
Cary, NC 27518-9306
Phone (919) 524-6551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L004141NCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Nutrition & Diabetes Counseling Center of NC, LLC Dietitian, Registered CurrentSince May 8, 2022 Accepting new patients

Locations

527 Keisler Dr
Ste 101
Cary, NC 27518
Phone (919) 434-6147

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1952642175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 KEISLER DR STE 101",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187084",
            "telephone_number": "919-524-6551",
            "fax_number": "844-364-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 KEISLER DR STE 101",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27518",
            "telephone_number": "919-524-6551",
            "fax_number": "844-364-9280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Keisler Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "27518",
            "country_code": "US",
            "telephone_number": "919-524-6551",
            "fax_number": "844-364-9280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MARIA",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "MPH, RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-13",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L004141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.