Practitioner Resources

Helping you, help others.

Hi all! As a fellow CNS (Certified Nutrition Specialist), trust me when I say I know how hard it can be to break out to make a name for yourself. I believe knowledge should be share and have provided some resources that I have created & put together for you in hopes that my experiences can benefit others. Additionally, I have also credited some of my colleagues/peers who are doing amazing things, so please show them some love & check their pages out as well!

CNS Candidates

  • What is a CNS?

  • What paperwork do I need for the BCNS exam? It'‘ll vary by school, but in my time, this was the list of all the classes that I could consider taking before sitting for the exam.

  • What internship should I do?

    • In-person or Online mentorships are available

    • Look for an internship program that are well structured to guide you every step of the way to prepare you for the CNS exam and set you for success in completing your hours (e.g. Clinician’s Incubator, Nutrition & Herbal Collective) - NOTE: I am not affiliated with any of these, they’re just other MUIH alumni that I’d like to support & have heard great things about!

    • You can also find supervised internships from nutrition practitioners who have been practicing for at least 3 years (these can range from $0 to $1K+ for 6 months). I did two internships, one in private practice for $0 and another as part of my school’s Experiential program for $1,200. Some peers reached out to former professors who were practicing and were charged $1K for 6 months of supervision. It just depends on who you ask!

Practice Makes Perfect.

Congrats! You just passed the CNS exam & have your LDN to start clinical practice … now what?

There are many career paths you can go from here since nutrition is pretty flexible amongst healthcare fields, and based on the state you’re in, it can be smooth sailing or quite a bumpy ride. Here’s my experience for both:

I’m not going to sugar coat it. California is not an easy state to start a nutrition practice (the CA tax alone is $800/yr)! I applied to dozenS of jobs, but all they wanted was an RD - which is understandable as they are the only ones with title protection here, and in many other states. If you’re in a state that licenses both, CNS and RDs, under the same LDN license like Maryland does, it’ll be much easier to find a job. It wasn’t until I earned my DCN degree that I really stood out from the crowd and demonstrated that I had earned the highest level of knowledge and skills a school could offer to be a nutrition professional. Once here, I was able to branch into:

Teaching - I started off as an adjunct professor in anatomy and physiology and the transitioned into facilitating courses within the master’s and doctoral nutrition program at various schools.

Biotech Lab - I heard through a Nutrition Facebook group that there was a job opening at a functional lab company. Now I help practitioners like you interpret conventional and functional lab tests!

Private Practice - Once you’ve determined your niche, you can starting honing your skills here! See next column on how to get started.

Things I Wish I Knew When I Started My Private Practice

Unless you’re extremely business savvy, I highly recommended enrolling in a business building class! (I did mine with a former professor, Camille Freeman, who is the absolute sweetest)! From there you can look into:

  • Company Name - if you’re in CA, check here to see if it’s already taken.

  • Making a Logo - you can either pay someone to do it or if you’re like me, you can doodle something and create it in Adobe Photoshop/Canva!

  • Forming an LLC/S-Corp - I definitely wanted to make sure I got all the correct paperwork done so I had a business lawyer help me out and explain the advantages of S-Corp vs LLC!

  • Professional Liability Insurance - I chose TRMS for the low annual fee and services covered (again, not affiliated, just sharing what I’ve done).

  • Hiring a CPA - Optional, but it really helps if you don’t want to deal with calculating all of of the taxes yourself!

  • How to Determine a Fee Schedule - Determining a fee schedule will vary by area and expertise. I recommend checking what other nutrition professionals in your area are charging & either match theirs or adjust your price based on how much you think your skills, knowledge, and services should be valued at.

Disclaimer: This post is not to be interpreted as legal advice (since I’m not a lawyer) but to help those in California know what their scope of practice is in regard to MNT, insurance, and ordering lab tests.

  • (a)(1) Notwithstanding any other law, a registered dietitian, or other nutritional professional meeting the qualifications set forth in subdivision (e) of Section 2585 may, upon referral by a health care provider authorized to prescribe dietary treatments, provide nutritional and dietary counseling, conduct nutritional and dietary assessments, and develop and recommend nutritional and dietary treatments, including therapeutic diets, for individuals or groups of patients in licensed institutional facilities or in private office settings.  

    The referral for medical nutrition therapy shall be accompanied by a written prescription signed by the health care provider detailing the patient’s diagnosis and including either a statement of the desired objective of dietary treatment or a diet order.  The registered dietitian, or other nutritional professional meeting the qualifications set forth in subdivision (e) of Section 2585 , may perform nutritional assessments and initiate nutritional interventions within the parameters of the prescribed diet order pursuant to a licensed health care facility’s approved nutrition screening policy and procedure. The registered dietitian, or other nutritional professional meeting the qualifications set forth in subdivision (e) of Section 2585 , shall collaborate with a multidisciplinary team, which shall include the treating physician and the registered nurse, in developing the patient’s nutrition care plan.  Unless otherwise stated in the diet order by a patient’s provider, the registered dietitian, or other nutritional professional meeting the qualifications set forth in subdivision (e) of Section 2585 , may individualize the patient’s nutritional or dietary treatment when necessary, by modifying the distribution, type, or quantity of food and nutrients within the parameters of the diet order. Any modification, and the rationale for the modification, shall be documented in the patient’s record for review by the practitioner, or other licensed health care professional, who is legally authorized to prescribe and is responsible for the care of the patient. Nothing in this subdivision shall be construed to authorize a registered dietitian, or other nutritional professional meeting the qualifications set forth in subdivision (e) of Section 2585 , to order or administer a central vein or peripheral vein nutrition.

    California Code, Business and Professions Code – BPC § 2585

    Take home message:

    Yes, a qualified CNS can provide MNT. This has been interpreted as a requirement for dietitians and qualified nutrition professionals to have a medical referral in hand prior to providing any dietary advice to clients in the state if you are intending to provide medical nutrition therapy. Outside of the physician’s referral, any advice and guidance on nutrition should be within the nutritonists’s scope of practice.

    You can find the exact wording of the state law here: California Code, Business and Professions Code – BPC § 2585 | FindLaw

  • Under current CMS MNT Credentialing requirements, § 410.134 Provider qualifications, Certified Nutrition Specialists CAN take insurance [x].

    For Medicare Part B coverage of MNT, only a registered dietitian or nutrition professional may provide the services. “Registered dietitian or nutrition professional”means an individual who, on or after December 22, 2000:

    (a) Holds a bachelor's or higher degree granted by a regionally accredited college or university in the United States (or an equivalent foreign degree) with completion of the academic requirements of a program in nutrition or dietetics accredited by an appropriate national accreditation organization recognized for this purpose.

    (b) Has completed at least 900 hours of supervised dietetics practice under the supervision of a registered dietitian or nutrition professional.

    (c) Is licensed or certified as a dietitian or nutrition professional by the State in which the services are performed. In a state that does not provide for licensure or certification, the individual will be deemed to have met this requirement if he or she is recognized as a “registered dietitian” by the Commission on Dietetic Registration or its successor organization, or meets the requirements of paragraphs (a) and (b) of this section.

    At Starberrie Nutrition, I currently do not accept insurance but can provide you with a health claim form known as a “superbill,” which you may be able to submit to your insurance for possible reimbursement.

  • Direct Access Testing: 1246.5

    Notwithstanding any other provision of law, any person may request, and any licensed clinical laboratory or public health laboratory may perform, the laboratory tests specified in this section. A registered clinical laboratory may perform the laboratory tests specified in this section if the test is subject to a certificate of waiver under CLIA and the laboratory has registered with the department under paragraph (2) of subdivision (a) of Section 1265. A program for nondiagnostic general health assessment that includes a laboratory test specified in this section shall comply with the provisions of Section 1244. The results from any test may be provided directly to the person requesting the test if the test is on or for his or her own body. These test results shall be provided in a manner that presents clear information and that identifies results indicating the need for referral to a physician and surgeon.

    The tests that may be conducted pursuant to this section are: pregnancy, glucose level, cholesterol, occult blood, and any other test for which there is a test for a particular analyte approved by the federal Food and Drug Administration for sale to the public without a prescription in the form of an over-the-counter test kit. A test approved only as an over-the-counter collection device may not be conducted pursuant to this section.

    While you may practice nutrition consultation as it pertains to food, nutrition intake, meal planning, grocery list, and recipe creation and nutritional assessment, you may not:

    “…practice medicine or to undertake the diagnosis, prevention, treatment, or cure of any disease, pain, deformity, injury, or physical or mental condition and specifically does not authorize any person other than one who is a licensed health practitioner to state that any product might cure any disease, disorder, or condition.”– California Code, Business and Professions Code – BPC § 2068

    California’s nutrition law can be found in the California Business and Professions Code, sections 2585, 2586, 2586.2, 2586.4, 2586.6, 2586.8, 2053.6, and 2068. 

    https://california.public.law/codes/ca_bus_and_prof_code_section_2585

    https://california.public.law/codes/ca_bus_and_prof_code_section_2586

    https://california.public.law/codes/ca_bus_and_prof_code_section_2586.2

    https://california.public.law/codes/ca_bus_and_prof_code_section_2586.4

    https://california.public.law/codes/ca_bus_and_prof_code_section_2586.6

    https://california.public.law/codes/ca_bus_and_prof_code_section_2586.8

    http://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=2053.6.&lawCode=BPC

    https://california.public.law/codes/ca_bus_and_prof_code_section_2068


    California Regulations on Laboratory Testing

    California allows for Direct Access Testing, which means anyone may order a select number of “nondiagnostic general health” tests.

    The law states: 

    “The tests that may be conducted pursuant to this section are: pregnancy, glucose level, cholesterol, occult blood, and any other test for which there is a test for a particular analyte approved by the federal Food and Drug Administration for sale to the public without a prescription in the form of an over-the-counter test kit. A test approved only as an over-the-counter collection device may not be conducted pursuant to this section.” – (BUSINESS AND PROFESSIONS CODE – BPC, 1246.5.)

    http://leginfo.legislature.ca.gov/faces/codes_displayText.xhtml?lawCode=BPC&division=2.&title=&part=&chapter=3.&article=3.

    Take home message:

    In California, qualified nutrition professionals CAN order certain types of lab tests, but there are limitations. These nutritionists are allowed to order “nondiagnostic general health” tests, which are used for general health assessments rather than for diagnosing or treating specific medical conditions. This includes tests like food sensitivity testing, micronutrient testing, and stool analysis, as long as the tests are classified under the general wellness category and not used for diagnosing diseases. However, they cannot perform tests that are strictly diagnostic without proper medical licensing​.

    Additionally, while anyone can provide nutritional advice in California, it’s important that nutrition professionals stay within the scope of their practice and avoid implying that they can diagnose, treat, or cure diseases​.

Want to learn more about CNS pathways?

Feel free to reach out to me!