Today’s Dietitian
Vol. 27 No. 8 P. 48
Telehealth and virtual nutrition practices were on the rise even before the pandemic made working from home the new normal for many dietitians. While this removed geographical boundaries for seeing patients and clients, it didn’t remove the legal boundaries associated with state licensure. While a few states don’t have licensure of any type, and others restrict use of the title “[state] licensed registered dietitian” but not the specific practice of MNT, these murky waters would be simpler to navigate with confidence if it was easier and less expensive to be licensed in multiple states.
That wish may soon become reality, thanks to the Dietitian Licensure Compact. The compact is an agreement between states similar to what you experience when you are legally allowed to drive throughout the country with a driver’s license from your home state. Many other health professions already have licensure compacts, including social workers, dentists and dental hygienists, nurses, physical therapists, occupational therapists, and massage therapists. The Dietitian Licensure Compact is also a benefit for patients, because it can increase their access to skilled dietitians.
“The Dietitian Licensure Compact is a game-changer for RDs practicing in the age of telehealth. It removes unnecessary barriers to care by allowing licensed dietitians to provide services across state lines more efficiently, helping patients access qualified nutrition professionals no matter where they live,” says Charla Burill, JD, RD, senior director of state legislative and government affairs at the Academy of Nutrition and Dietetics (the Academy).
The Academy started exploring the feasibility of a compact back in 2019, gaining a significant boost in October 2022 when the Department of Defense provided funding for the Academy to work with The Council of State Governments’ National Center for Interstate Compacts.1,2 A year later, the Dietitian Licensure Compact legislation was ready, and in April 2024, Nebraska became the first state to pass it.
Current Requirements and Expectations
As of August 2025, 15 states—Nebraska, Alabama, Tennessee, Ohio, South Dakota, North Dakota, Mississippi, Utah, Kansas, Montana, Arkansas, Iowa, Oklahoma, Rhode Island, and Wisconsin—have passed the legislation.1 When Mississippi joined as the seventh state, this triggered the formation of the Compact Commission, which will include one member from each participating state and develop the rules and processes needed to make the compact fully operational.3 The inaugural meeting is expected early this fall, and the full implementation process could take another year or more.2,4
To participate in the compact, states must license and regulate the practice of dietetics and nutrition, require licensees to pass a nationally recognized exam approved by the Compact Commission and complete continuing education, and have a mechanism in place for receiving and investigating complaints about licensees.2
Once the compact is fully operational, the ability of an individual dietitian to choose to participate hinges on whether their primary state of residence—their home state—participates in the compact. If so, a dietitian can choose to enroll in the compact if they can achieve the following:
• an active and unencumbered license in that state;
• meet the requirements to be an RD;
• meet any legal requirements;
• pass a background check; and
• pay all required fees.
The compact won’t change participating states’ requirements for an initial license or license renewal, but it’s expected that fees will be lower than the fee to be independently licensed in those states. The idea is to encourage dietitians’ participation in the compact.2
States that don’t license or certify dietitians—currently California, Colorado, Virginia, Michigan, and Arizona—won’t be eligible to participate in the compact, which means dietitians in those states won’t be able to benefit from the compact.2 Also, the necessary background check will be a sticking point for dietitians in home states that don’t require a background check for licensure. For example, dietitians in Maryland who advocated for their state to join the compact were told that the state would not participate because it doesn’t require a background check and does not plan to add that requirement for licensure.
Dietitians with a home state not in the compact can still apply for an individual license in a compact state. For example, a dietitian in California or Maryland who wants to see clients in Ohio can apply for a license there. Beyond establishing an applicant’s qualifications to be a dietitian, licensure requirements can vary widely. For example, Pennsylvania requires three hours of training in child abuse detection and reporting, Texas requires passing a jurisprudence exam, and Tennessee requires a signed recent professional recommendation and a signed recent passport photo. And many states require background checks.
It’s also important to note that being licensed in a home state participating in the compact doesn’t mean a dietitian will automatically be able to practice in all the states in the compact. They will have to notify the Compact Commission that they seek a compact privilege with one or more of the other member states. What the compact does is make it easier and more cost effective to apply for licensure in participating states and will reduce the fee amount. And that’s a win for dietitians.
— Carrie Dennett, MPH, RDN, is the nutrition columnist for The Seattle Times, owner of Nutrition By Carrie, and author of Healthy for Your Life: A Non-Diet Approach to Optimal Well-Being.
References
1. Dietitian Licensure Compact timeline. Academy of Nutrition and Dietetics website. https://www.eatrightpro.org/-/media/files/eatrightpro/advocacy/dietitian-licensure-compact-timeline.pdf?rev=8df8ca9917ff47f48fcd1ef3cfa0aa73. Accessed July 10, 2025.
2. Dietitian Licensure Compact. The Council of State Governments website. https://dietitianscompact.org. Accessed July 10, 2025.
3. Mississippi becomes the seventh state to enact the Dietitian Licensure Compact, triggering commission formation. Academy of Nutrition and Dietetics website. https://www.eatrightpro.org/news-center/public-policy-news/mississippi-becomes-the-seventh-state-to-enact-the-dietitian-licensure-compact. Published March 25, 2025. Accessed July 12, 2025.
4. Dietitian Licensure Compact. Academy of Nutrition and Dietetics website. https://www.eatrightpro.org/advocacy/licensure/dietitian-licensure-compact. Accessed July 12, 2025.
