MACKENZIE DOUGHERTY RD, CD
NPI 1053612283
Dietitian, Registered in Saint Paul, MN

Active since November 04, 2010Accepts Medicare Assignment
2265 COMO AVE, SAINT PAUL, MN 55108(651) 645-5323 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 17, 2018, Mar 7, 2018 (2 updates tracked since 2018).

About Mackenzie Dougherty Rd, Cd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MACKENZIE DOUGHERTY RD, CD (NPI 1053612283) is an individual dietitian, registered in Saint Paul, Minnesota, licensed in Minnesota (3882) and active in the NPI registry since November 2010. She maintains a secondary practice location in Madison and is a graduate of Other (2002).

NPPES Registry Identity

NPI1053612283
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameMACKENZIE DOUGHERTYCredential: RD, CD
Location Address2265 COMO AVESaint Paul, MN 55108-1737
Mailing Address2265 Como AveSaint Paul, MN 55108-1737
Sole ProprietorYes
Medical School CMSOtherGraduated 2002
Enumeration DateNovember 4, 2010
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
NPI 1053612283 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License Licensed in MN · 3882
Definition

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

2265 COMO AVE, Saint Paul, MN 55108

Secondary Practice Location 1

Location 1600 Highland Ave, MC 1510Madison, WI 53792-0001 · Phone (608) 890-8299

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mackenzie Dougherty Rd, Cd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9436335056
PECOS Enrollment IDI20180418001422

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55108 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $56.00 – $168.28
Typical copayment $0.00 (range $14.00 – $42.07)
Most-billed visit code NA
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nutritionist
2265 COMO AVE
SAINT PAUL, MN 55108
Counselor (Professional)
2265 COMO AVE
SAINT PAUL, MN 55108
Dietitian, Registered
2265 COMO AVE
SAINT PAUL, MN 55108
Student in an Organized Health Care Education/Training Program
2265 COMO AVE
SAINT PAUL, MN 55108
Marriage & Family Therapist
2265 COMO AVE
SAINT PAUL, MN 55108
Counselor (Professional)
2265 COMO AVE
SAINT PAUL, MN 55108
Dietitian, Registered
2265 COMO AVE
SAINT PAUL, MN 55108
Dietitian, Registered
2265 COMO AVE
SAINT PAUL, MN 55108

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mackenzie Dougherty's NPI number?

The NPI number for Mackenzie Dougherty is 1053612283. It was assigned to this individual provider in the NPPES registry on November 4, 2010.

Where is Mackenzie Dougherty located?

Mackenzie Dougherty practices at 2265 Como Ave, Saint Paul, MN 55108. The listed phone number is (651) 645-5323.

What is Mackenzie Dougherty's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Mackenzie Dougherty enrolled in Medicare?

Yes. Mackenzie Dougherty is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mackenzie Dougherty accept?

Health plans from Medica list Mackenzie Dougherty as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mackenzie Dougherty was last updated on March 17, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.