How to start a private practice as a dietitian: a dated checklist

How do you start a private practice as a registered dietitian? Work through twelve steps in this order: licensure where your clients are, a one-page plan, a business structure, an EIN if you need one, an NPI, liability insurance, cash pay or insurance, a HIPAA check, the Good Faith Estimate, booking software, a name and domain, and a simple website. We checked each official page linked below on October 12, 2026. This is general information, not legal, tax or insurance advice. Each step says what to check and with whom.

Which steps change by state?

Licensure, business registration and local permits change by state, and so can insurance rules. The EIN and NPI are federal. HIPAA and the Good Faith Estimate are federal rules, and your state may add its own.

What are the steps, in order?

1. Licensure: check each state where your clients are

Your RD credential is not a state license. The Commission on Dietetic Registration (CDR) says most states require dietitians to hold a state license or certification to practice or to use a protected title, and that requirements vary. CDR and the Academy of Nutrition and Dietetics strongly recommend holding licensure or certification in every state where your clients are when you see them, unless an exemption applies or the state has no requirement.

For telehealth, CDR says the legal status of cross-state practice is generally decided by the client's location. Some state telehealth laws may let you practice if you are licensed in at least one state. Others require a license in that specific state. Check each state on its own.

Where: each state's licensing board, the Academy's Licensure Map and Statutes by State, and the Center for Connected Health Policy's state telehealth look-up, which has a "Cross-State Licensing" topic. As one example, Texas licenses dietitians through its Department of Licensing and Regulation. Its application page says a current CDR registration means you have met the education, experience and exam requirements to apply, and asks for proof of passing a Texas jurisprudence exam. That is one state, read on October 12, 2026, not a rule for yours.

The Dietitian Licensure Compact would let eligible RDs apply for a "privilege" in other member states. CDR expects the first privileges sometime in 2027, and says you would need an active license in your home state, which must be a compact state. For how to show your credentials and states, see explaining your credentials on your website.

2. A one-page plan

SBA says there is no right or wrong way to write a plan, and that most are either traditional (detailed, and commonly requested by lenders and investors) or lean startup (key points only, typically one page, as little as an hour to write). If you fund the practice yourself, one page may be enough: who you help, what you offer, how clients pay, what you expect to spend before the first client, and how people will find you.

Where: SBA's Write your business plan.

3. Business structure and registration

SBA says a sole proprietorship is easy to form, but the business and the owner are not legally separate, so you can be personally liable for business debts. LLC members are generally protected from personal liability for business debts and lawsuits. Both generally pass profits to your personal return, with self-employment tax. SBA says to choose carefully, because changing later can be restricted and have tax consequences. Ask an attorney and an accountant what each structure would cover in a professional practice.

An LLC or corporation usually registers with the state, often through the Secretary of State. You might also need to register a trade name (a DBA) with your state, county or city.

Where: SBA on structure, registering and licenses and permits.

4. EIN, a bank account and taxes

An EIN is the IRS number for a business. The IRS says you need one if you have employees or will owe employment or excise taxes, and that partnerships, LLCs and corporations need one to operate. Its list does not name a sole proprietor with none of that, and SBA says a bank may take a Social Security number from a sole proprietorship in place of an EIN. The IRS adds that you can still request an EIN for banking or state tax purposes. Ask your accountant whether to get one anyway.

Apply directly with the IRS. It says an EIN is free and warns about sites that charge for one. A separate business bank account keeps business money apart from personal money, says SBA. The IRS says sole proprietors generally make estimated tax payments if they expect to owe $1,000 or more in tax when they file.

Where: the IRS pages to apply for an EIN, on who needs one and on estimated taxes.

5. An NPI

An NPI is a 10-digit number that identifies you as a health care provider. CMS's older NPI guide (August 2014) says any health care provider may get one, HIPAA-covered providers must, and a sole proprietor applies with their own Social Security number. It adds that an NPI does not license you or enroll you in a health plan. Even if you take no insurance, you will likely want one: CMS's sample Good Faith Estimate has a field for it, the older guide says you must have an NPI to enroll in Medicare, and the first step in CMS's Medicare enrollment guide is to get one.

Where: CMS says the web-based NPPES system is the most efficient way to apply. A paper form is also available.

6. Professional liability insurance

SBA describes professional liability insurance as coverage against financial loss from malpractice, errors and negligence, and says insurance laws vary by state. It suggests finding a licensed agent and comparing rates, terms and benefits from several different agents. We name no products. Ask any broker:

• Does it cover everything I will do, including telehealth, and in which states my clients will be?
• Is it claims-made or occurrence-based, and what happens to coverage if I close the practice?
• What does it exclude, and is data breach coverage included?

Where: SBA's Get business insurance.

7. Cash pay, insurance or both

Decide before you set fees, because it shapes your forms and paperwork. Cash pay means clients pay you directly. CMS calls people who have no insurance, or will not use it for a service, "uninsured (or self-pay)", except people in federal programs such as Medicare. Taking insurance usually means applying to each plan, and Medicare has its own process.

Where: each plan's provider page, and CMS's guide for providers who want to bill Medicare. Ask how long each takes.

8. HIPAA: find out whether you are a covered entity

HIPAA applies to covered entities and their business associates. CMS says a provider is covered if it submits certain transactions, such as claims, electronically. CMS's decision tool asks a provider two questions: do you furnish, bill or receive payment for health care in the normal course of business, and do you transmit any covered transactions electronically? Yes to both means you are covered. If you are not a covered entity or business associate, CMS says you do not have to follow the HIPAA rules.

If you are covered, CMS's fact sheet lists what that involves: telling patients their privacy rights, adopting privacy procedures and training staff, writing security policies and analyzing risks to electronic records, and reporting breaches to affected patients and HHS, for most no later than 60 days after discovery (smaller breaches are reported to HHS yearly). Ask each software vendor whether it will sign a business associate agreement.

If you are not covered, the FTC says its rules still apply. Sharing health information for advertising without affirmative express consent may be unfair, and you should not claim to be "HIPAA compliant" unless it is true.

9. The Good Faith Estimate for self-pay clients

If you practice under a state license or certification and any client will pay without using insurance, the Good Faith Estimate rule very likely applies to you. CMS says providers must give an estimate to people who don't have or use insurance when they schedule care at least 3 business days ahead or ask for one. The rules have applied since January 1, 2022. The estimate has fields for your NPI and Tax Identification Number, so finish steps 4 and 5 first. Our guide covers who is included (people in federal programs such as Medicare are not), the deadlines, the website notice and what the estimate holds: do dietitians need a Good Faith Estimate?

Where: CMS's No Surprises Act pages for providers.

10. Practice-management and booking software

This is a category, not a product. One tool, or a small set, usually covers scheduling, intake forms, notes, secure messages, payments and video. Features and prices differ, so read each vendor's current pages. We rank none. Ask each one:

• Will it sign a business associate agreement if I am covered?
• Where do clients fill out intake and consent forms, so none sit on my public site?
• What are the fees, and can I export my data if I leave?

Your website should link to the booking page and nothing more.

11. A business name and a domain

Pick a name you can say aloud and spell, such as your own name plus "Nutrition," and avoid names that promise a result. SBA says to check prospective names against the official trademark database, and that most states will not let you register an entity name someone else already registered. A domain does not have to match your legal name, trademark or DBA, says SBA. Register it through a registrar. If you see clients in person, use the same name on your Google Business Profile; see our Google Business Profile guide.

Where: SBA's Choose your business name.

12. A website that says who you help and how to book

A first version can be short: your credential, who you help, the states you are licensed in, how payment works and one booking link. CDR's guidelines say that in written text the phrase to be used is "registered dietitian" or "registered dietitian nutritionist." Our dietitian website checklist has the page-by-page version, including the fees and privacy pages.

A website does not bring clients on its own. Clear, complete pages improve your odds with clients, Google and AI assistants; see how AI assistants choose which dietitians to mention. If you want a starting point, you can draft a free preview of your site.

What should your first week look like?

Some steps take longer than a week, such as a state license or joining an insurance plan. Use week one to start them.

• Day 1. List every state where you expect clients and note what each board requires.
• Day 2. Write the one-page plan, including cash pay, insurance or both.
• Day 3. Ask two or three licensed agents for liability quotes. Book a call with an accountant or attorney.
• Day 4. Apply for an EIN if you need one, and for your NPI.
• Day 5. Look at one practice-management tool and ask the business associate agreement question.
• Day 6. Search the trademark database and register the domain.
• Day 7. Draft a simple site with one booking link and your licensed states. Ask your board about advertising rules before you publish it.

What are the common mistakes?

• Treating your RD credential as a license. CDR says they are different processes.
• Counting only your home state. For telehealth, the client's location generally decides.
• Skipping estimated taxes. The IRS says people in business for themselves generally need to make them.
• Taking the first insurance quote. SBA suggests comparing several agents.
• Putting intake forms or health questions on your public site.
• Calling your site "HIPAA compliant" without a basis. The FTC warns against false claims.
• Choosing a name without a trademark search.

How do you check that you finished?

Look yourself up. Search the NPI Registry for your own record, and check your license on your state board's page if it has a look-up. Read your insurance certificate and confirm it names your services and your clients' states. Repeat this twice a year, because pages and rules change.