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KATHERINE THERESE MAXEY MA
NPI 1194471623
Counselor - Mental Health in Fortuna, CA

Active since February 23, 2022PECOS EnrolledAccepts Medicare Assignment
3429 RENNER DR, FORTUNA, CA 95540(707) 296-9295 Get Directions Write a Review

NPPES record last updated: February 23, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Katherine Therese Maxey Ma NPPES

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

KATHERINE THERESE MAXEY MA (NPI 1194471623) is an individual mental health provider in Fortuna, California, licensed in California (AMFT114333) and active in the NPI registry since February 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1194471623
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKATHERINE THERESE MAXEYCredential: MA
Location Address3429 RENNER DRFortuna, CA 95540-3104
Mailing AddressPo Box 362Cutten, CA 95534-0362
Phone(707) 296-9295
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateFebruary 23, 2022
NPPES CertifiedFebruary 23, 2022
✔ NPI 1194471623 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in CA · AMFT114333
3429 RENNER DR, Fortuna, CA 95540
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Katherine Therese Maxey Ma 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 ID9739684192
PECOS Enrollment IDI20250925003460
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Katherine Maxey reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Humboldt Neurohealth Therapeutic Services
Adult Mental Health
3429 RENNER DR
Fortuna, CA 95540
  • Reassigned Medicare billing, California enrollment
  • 11 clinicians in this Medicare group
NPI 1710459292 (707) 298-9295

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 19

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

HUMBOLDT NEUROHEALTH THERAPEUTIC SERVICES
Case Manager/Care Coordinator
3429 RENNER DR
FORTUNA, CA 95540
Humboldt County (707) 296-9295
DR. KATHERINE ANNE TALBERT ESTLIN MD
Family Medicine
3429 RENNER DR
FORTUNA, CA 95540
Humboldt County (707) 726-2255
FELICE PHILIPS
Case Manager/Care Coordinator
3429 RENNER DR
FORTUNA, CA 95540
Humboldt County (707) 296-9295
ROCHELLE EILEEN TROCHTENBERG
Social Worker (Clinical)
3429 RENNER DR
FORTUNA, CA 95540
Humboldt County (707) 296-9295
ADALIZETTE AGUILAR
Case Manager/Care Coordinator
3429 RENNER DR
FORTUNA, CA 95540
Humboldt County (707) 296-9295
ALYSE JEANNE LAVERNE LMFT
Marriage & Family Therapist
3429 RENNER DR
FORTUNA, CA 95540
Humboldt County (707) 617-0323
JULIA HEMENWAY
Student in an Organized Health Care Education/Training Program
3429 RENNER DR
FORTUNA, CA 95540
Humboldt County (707) 296-9295
JENNIFER BROWN LCSW
Social Worker (Clinical)
3429 RENNER DR
FORTUNA, CA 95540
Humboldt County (707) 296-9295

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 Katherine Maxey's NPI number?

The NPI number for Katherine Maxey is 1194471623. It was assigned to this individual provider in the NPPES registry on February 23, 2022.

Where is Katherine Maxey located?

Katherine Maxey practices at 3429 Renner Dr, Fortuna, CA 95540. The listed phone number is (707) 296-9295.

What is Katherine Maxey's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Katherine Maxey enrolled in Medicare?

Yes. Katherine Maxey 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.

Which organization bills Medicare for Katherine Maxey's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Katherine Maxey reassigns Medicare benefits to Humboldt Neurohealth Therapeutic Services (Fortuna, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Katherine Maxey's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Katherine Maxey was last updated on February 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.