Provider Demographics
NPI:1780476820
Name:MACHACA, MARY MARGARET (RD, LD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:MARGARET
Last Name:MACHACA
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:DAWSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:7361 CALHOUN PL STE 600
Mailing Address - Street 2:
Mailing Address - City:DERWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20855-2788
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7361 CALHOUN PL STE 600
Practice Address - Street 2:
Practice Address - City:DERWOOD
Practice Address - State:MD
Practice Address - Zip Code:20855-2788
Practice Address - Country:US
Practice Address - Phone:301-942-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX7275133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered