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MCKENNA KING
NPI 1770027971
Dietitian, Registered in Glendale, AZ

Active since December 07, 2016
18001 N 79TH AVE STE A12, GLENDALE, AZ 85308(623) 399-6825 Get Directions Write a Review

NPPES record last updated: November 20, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mckenna King NPPES

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

MCKENNA KING (NPI 1770027971) is an individual dietitian, registered in Glendale, Arizona, licensed in Arizona (86359292) and active in the NPI registry since December 2016. She maintains a secondary practice location in Eureka and is a graduate of Other (2024).

NPPES Registry Identity

NPI1770027971
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameMCKENNA KING
Location Address18001 N 79TH AVE STE A12Glendale, AZ 85308-8398
Mailing Address3960 Walnut DrEureka, CA 95503-8938 · (707) 268-8722
Phone(623) 399-6825
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateDecember 7, 2016
Last NPPES UpdateNovember 20, 2024
NPPES CertifiedNovember 20, 2024
✔ NPI 1770027971 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in AZ · 86359292
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.
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
18001 N 79TH AVE STE A12, Glendale, AZ 85308
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Secondary Practice Location 1

Location 13960 Walnut DrEureka, CA 95503-8938 · Phone (707) 268-8722

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Imperial Insurance Companies, Inc..Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mckenna King is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4981130341
PECOS Enrollment IDI20260109001374

Medicare Billing Reassignment

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

San Carlos Apache Healthcare Corporation
106 mi
Critical Access Hospital
103 MEDICINE WAY ROAD
Peridot, AZ 85542
  • Reassigned Medicare billing, Texas enrollment
  • 438 clinicians in this Medicare group
NPI 1265813075 (928) 475-1200

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 20

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

AM NUTRITION SERVICES
Dietitian, Registered
18001 N 79TH AVE STE A12
GLENDALE, AZ 85308
Maricopa County (623) 399-6825
CARA JANSEN RD
Dietitian, Registered
18001 N 79TH AVE STE A12
GLENDALE, AZ 85308
Maricopa County (623) 399-6825
JACQUELINE CARBAJAL
Dietitian, Registered
18001 N 79TH AVE STE A12
GLENDALE, AZ 85308
Maricopa County (623) 399-6825
KELLY CREED RDN
Dietitian, Registered
18001 N 79TH AVE STE A12
GLENDALE, AZ 85308
Maricopa County (623) 399-6825
DAISHAWN ROYLANCE RD
Dietitian, Registered
18001 N 79TH AVE STE A12
GLENDALE, AZ 85308
Maricopa County (623) 399-6825
STEPHANIE CARPENTER RD
Dietitian, Registered
18001 N 79TH AVE STE A12
GLENDALE, AZ 85308
Maricopa County (623) 399-6825
JULIE ANNE NELSON RDN
Dietitian, Registered
18001 N 79TH AVE STE A12
GLENDALE, AZ 85308
Maricopa County (623) 399-6825
ANNALISA G AVERILL RD
Dietitian, Registered
18001 N 79TH AVE STE A12
GLENDALE, AZ 85308
Maricopa County (623) 399-6825

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 Mckenna King's NPI number?

The NPI number for Mckenna King is 1770027971. It was assigned to this individual provider in the NPPES registry on December 7, 2016.

Where is Mckenna King located?

Mckenna King practices at 18001 N 79th Ave Ste A12, Glendale, AZ 85308. The listed phone number is (623) 399-6825.

What is Mckenna King's specialty?

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

Is Mckenna King enrolled in Medicare?

Yes. Mckenna King is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mckenna King's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mckenna King reassigns Medicare benefits to San Carlos Apache Healthcare Corporation (Peridot, AZ). 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 Mckenna King's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mckenna King accept?

Health plans from Blue Cross Blue Shield of Arizona and Imperial Insurance Companies, Inc. list Mckenna King 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 Mckenna King was last updated on November 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.