Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

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

Active since August 02, 2005PECOS Enrolled
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: July 19, 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.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Theresa Mckenna is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
ST CHARLES HOSPITAL200 BELLE TERRE ROAD
PORT JEFFERSON, NY 11777
(631) 474-6000Acute Care Hospitals

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.

Pediatrics
200 BELLE TERRE RD
PORT JEFFERSON, NY 11777
Orthopaedic Surgery
200 BELLE TERRE RD
PORT JEFFERSON, NY 11777
Psychologist
200 BELLE TERRE RD
PORT JEFFERSON, NY 11777
Psychologist
200 BELLE TERRE RD
PORT JEFFERSON, NY 11777
Psychologist (Clinical)
200 BELLE TERRE RD
PORT JEFFERSON, NY 11777
Pathology (Anatomic Pathology & Clinical Pathology)
200 BELLE TERRE RD
PORT JEFFERSON, NY 11777
Pathology (Anatomic Pathology & Clinical Pathology)
200 BELLE TERRE RD
PORT JEFFERSON, NY 11777
Pathology (Anatomic Pathology & Clinical Pathology)
200 BELLE TERRE RD
PORT JEFFERSON, NY 11777

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1568463560, enumerated as an "individual" on August 02, 2005.

The provider is located at 200 BELLE TERRE RD PORT JEFFERSON, NY 11777 and the phone number is (631) 474-6000.

Psychologist with taxonomy code 103T00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.

Theresa Mckenna is affiliated with: ST CHARLES HOSPITAL.