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DR. MARY THERESA KENNEDY PHD
NPI 1861479636
Psychologist - Clinical in Bayside, NY

Active since December 22, 2005PECOS EnrolledAccepts Medicare Assignment
217-04 NORTHERN BLVD, STE 16, BAYSIDE, NY 11361(718) 631-8939 Get Directions Write a Review

NPPES record last updated: September 3, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Mary Theresa Kennedy Phd NPPES

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

DR. MARY THERESA KENNEDY PHD (NPI 1861479636) is an individual clinical provider in Bayside, New York, licensed in New York (00760201) and active in the NPI registry since December 2005. She is enrolled in Medicare PECOS and is a graduate of Other (1971).

NPPES Registry Identity

NPI1861479636
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. MARY THERESA KENNEDYCredential: PHD
Location Address217-04 NORTHERN BLVD, STE 16Bayside, NY 11361-3500
Mailing Address218-11 Horace Harding BlvdBayside, NY 11364-2211 · (718) 631-8939
Phone(718) 631-8939
Sole ProprietorYes
Medical School CMSOtherGraduated 1971
Enumeration DateDecember 22, 2005
Last NPPES UpdateSeptember 3, 2010
✔ NPI 1861479636 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in NY · 00760201
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
217-04 NORTHERN BLVD, Bayside, NY 11361
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Other Names 1

Other Name (5)Dr. Mary Theresa Reilly Phd

Other Identifiers 3

Medicare ID-Type Unspecified16174
Medicare UPINR27827
Medicaid01067481NY

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

Dr. Mary Theresa Kennedy 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 ID8921296054
PECOS Enrollment IDI20101216000144
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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 45 minutes 90834
Psychotherapy is a treatment method where you converse with a therapist about your thoughts, feelings, and behaviors. In a 45-minute session, the therapist assists you in understanding and managing your mental health concerns, improving emotional wellness, and promoting personal growth.
578 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11361 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
$201.98 typical visit price
range $67.00 – $201.98
Typical copayment $50.49 (range $16.75 – $50.49)
Most-billed visit code 99205
Established Patient
$116.96 typical visit price
range $21.62 – $163.52
Typical copayment $29.24 (range $5.40 – $40.88)
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.

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 Mary Kennedy's NPI number?

The NPI number for Mary Kennedy is 1861479636. It was assigned to this individual provider in the NPPES registry on December 22, 2005. The provider is also known as Dr. Mary Theresa Reilly Phd.

Where is Mary Kennedy located?

Mary Kennedy practices at 217-04 Northern Blvd Ste 16, Bayside, NY 11361. The listed phone number is (718) 631-8939.

What is Mary Kennedy's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Mary Kennedy enrolled in Medicare?

Yes. Mary Kennedy 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.

When was this NPI record last updated?

The NPPES record for Mary Kennedy was last updated on September 3, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.