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MD NUTRITION AND LIFESTYLE, LLC
NPI 1972002301
Dietitian, Registered in Kingstowne, VA

Active since February 12, 2018
5901 KINGSTOWNE VILLAGE PKWY, SUITE 300, KINGSTOWNE, VA 22315(860) 796-1930 Get Directions Write a Review

NPPES record last updated: February 12, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Md Nutrition And Lifestyle, Llc NPPES

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

MD NUTRITION AND LIFESTYLE, LLC (NPI 1972002301) is a healthcare organization registered as a dietitian, registered in Kingstowne, Virginia and active in the NPI registry since February 2018. The organization lists Mara Michele Davis, Clinical Dietitan, as its authorized official.

NPPES Registry Identity

NPI1972002301
Entity TypeOrganization
Primary Taxonomy133V00000X
Legal Business NameMD NUTRITION AND LIFESTYLE, LLC
Location Address5901 KINGSTOWNE VILLAGE PKWY, SUITE 300Kingstowne, VA 22315
Mailing Address95 Bretton RdMiddletown, CT 06457 · (860) 796-1930
Phone(860) 796-1930
Organization SubpartNo
Authorized OfficialMara Michele DavisClinical Dietitan · (860) 796-1930
Enumeration DateFebruary 12, 2018
✔ NPI 1972002301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
Licenses✔ Licensed in NC · L002913✔ Licensed in CT · 001415
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.
5901 KINGSTOWNE VILLAGE PKWY, Kingstowne, VA 22315
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Md Nutrition And Lifestyle, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to MD Nutrition And Lifestyle, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Mara Davis, MS, RD, CD-N, LDN
Registered Dietitian or Nutrition Professional
NPI 1790076883
5901 KINGSTOWNE VILLAGE PKWY STE 300
Alexandria, VA 22315
(860) 796-1930
✔ Accepts Medicare0.3 mi

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

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 MD Nutrition And Lifestyle, LLC's NPI number?

The NPI number for MD Nutrition And Lifestyle, LLC is 1972002301. It was assigned to this organization in the NPPES registry on February 12, 2018.

Where is MD Nutrition And Lifestyle, LLC located?

MD Nutrition And Lifestyle, LLC is located at 5901 Kingstowne Village Pkwy Suite 300, Kingstowne, VA 22315. The listed phone number is (860) 796-1930.

What is MD Nutrition And Lifestyle, LLC's specialty?

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

Is MD Nutrition And Lifestyle, LLC enrolled in Medicare?

Yes. MD Nutrition And Lifestyle, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through MD Nutrition And Lifestyle, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Registered Dietitian or Nutrition Professional) reassigns their Medicare billing to MD Nutrition And Lifestyle, LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for MD Nutrition And Lifestyle, LLC was last updated on February 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.