Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

THERESA ANN MCKENNA PHD
NPI 1568463560
Psychologist in Port Jefferson, NY

Active since August 02, 2005PECOS EnrolledAccepts Medicare Assignment
200 BELLE TERRE RD, PORT JEFFERSON, NY 11777(631) 474-6000 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Theresa Ann Mckenna Phd NPPES

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

THERESA ANN MCKENNA PHD (NPI 1568463560) is an individual psychologist in Port Jefferson, New York, licensed in New York (013779) and active in the NPI registry since August 2005. She is enrolled in Medicare PECOS, is affiliated with St Charles Hospital, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1568463560
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameTHERESA ANN MCKENNACredential: PHD
Location Address200 BELLE TERRE RDPort Jefferson, NY 11777-1928
Mailing Address200 Belle Terre RdPort Jefferson, NY 11777-1928 · (631) 474-6000
Sole ProprietorNo
Medical School CMSOtherGraduated 1998
Enumeration DateAugust 2, 2005
Last NPPES UpdateJuly 13, 2026
NPI 1568463560 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in NY · 013779
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
200 BELLE TERRE RD, Port Jefferson, NY 11777

Other Identifiers 1

Medicaid013779NY

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

Theresa Ann Mckenna Phd 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 ID7416056171
PECOS Enrollment IDI20070620000509
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Charles Hospital

Acute Care Hospitals · Port Jefferson, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number330246
Location200 Belle Terre RoadPort Jefferson, NY 11777 · Suffolk County
Birthing friendly

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.

Emergency Medicine
200 BELLE TERRE RD
PORT JEFFERSON, NY 11777
Audiologist-Hearing Aid Fitter
200 BELLE TERRE RD
PORT JEFFERSON, NY 11777
Physical Therapist
200 BELLE TERRE RD
PORT JEFFERSON, NY 11777
Occupational Therapist (Pediatrics)
200 BELLE TERRE RD
PORT JEFFERSON, NY 11777
Physician Assistant
200 BELLE TERRE RD
PORT JEFFERSON, NY 11777
Pediatrics
200 BELLE TERRE RD
PORT JEFFERSON, NY 11777
Physician Assistant
200 BELLE TERRE RD
PORT JEFFERSON, NY 11777
Pharmacist
200 BELLE TERRE RD
PORT JEFFERSON, NY 11777

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 Theresa Mckenna's NPI number?

The NPI number for Theresa Mckenna is 1568463560. It was assigned to this individual provider in the NPPES registry on August 2, 2005.

Where is Theresa Mckenna located?

Theresa Mckenna practices at 200 Belle Terre Rd, Port Jefferson, NY 11777. The listed phone number is (631) 474-6000.

What is Theresa Mckenna's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Theresa Mckenna enrolled in Medicare?

Yes. Theresa Mckenna 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.

Is Theresa Mckenna affiliated with any hospitals?

According to CMS data, Theresa Mckenna is affiliated with St Charles Hospital.

When was this NPI record last updated?

The NPPES record for Theresa Mckenna was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 39 days 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.