Amanda Ruth Mahnke, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

11733 Issued in MA

Practice address

625 Mount Auburn St Ste 205a
Cambridge, MA 02138-4530

Phone

(857) 760-0210

NPI assigned

Apr 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1972183499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 KENWOOD ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022704",
            "telephone_number": "202-680-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 MOUNT AUBURN ST STE 205A",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384530",
            "telephone_number": "857-760-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHNKE",
        "first_name": "AMANDA",
        "middle_name": "RUTH",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-09",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "11733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yutika Maharaj, DMD
• Aidyn Lane Maher, CNA
• Katherine Ann Maher, RN
• Patricia Maher, APRN
• Sheila Maher, PHD
• Elaine Marie Mahoney, RN, MN
• Maryann Mahoney, RN
• Erin Margaret Mahony, MD
• Erin Kinney Maidman
• Inger M Maier, PH.D.

• Clinical Psychologist in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.