Dietitian Licensure Compact: 2026 Status, Telehealth Rules

A dietitian may see an out-of-state client only on that state's terms: as of September 2026 the Dietitian Licensure Compact is law in nineteen states but has issued no privileges. A practice-exclusive state needs its own license, a title-only or certification state generally needs nothing if you avoid the protected title, and Florida, Delaware and Vermont offer telehealth registration. NutraPlanner scheduling links handle time zones and can give each video booking its own Google Meet room when a Google Calendar is connected.

Key takeaways

The compact activated on March 21, 2025, when the seventh state enacted it. Its Commission first met in November 2025, issued a request for proposals for its data system in March 2026, was still discussing the draft compact-privilege rule on August 20, 2026, and has the draft rule on obtaining a new home-state license on its September 17 agenda. No privileges have been issued.
Nineteen jurisdictions have enacted it: Alabama, Arkansas, Georgia, Iowa, Kansas, Kentucky, Mississippi, Missouri, Montana, Nebraska, North Dakota, Ohio, Oklahoma, Rhode Island, South Dakota, Tennessee, Utah, Washington and Wisconsin. Washington's takes effect July 1, 2028.
A privilege will require an active license in the dietitian's home state. A dietitian living in Arizona, California, Colorado or Virginia, which issue no license, cannot use the compact even once it is live.
Where the practice is reserved, serving a client physically in the state generally requires that state's license. North Carolina, Iowa, Illinois, Maryland, Alabama and DC say so expressly; Georgia and Montana add narrow temporary-presence exemptions.
Texas requires no license to serve a Texas client by telehealth unless the dietitian uses "licensed dietitian" or "LD" with that client. Most title-only and certification states impose no practice bar. Pennsylvania is unresolved, because its Department of State and its statute point different ways.
Florida, Delaware and Vermont run a telehealth registration a dietitian can use instead of a license. West Virginia’s interstate telehealth statute also requires a registration and names the dietitian article, and Arizona’s has no board to administer it. Florida's requires liability coverage, which the Department of Health's form fixes at $100,000 per claim and $300,000 aggregate, and bars opening a Florida office.

Is the Dietitian Licensure Compact in effect?

The compact is enacted, but no dietitian can practice under it yet. It "officially became enacted" on March 21, 2025, when Mississippi, Alabama, Tennessee, Ohio, North Dakota, South Dakota and Nebraska brought it to the seven-state threshold, and its Commission convened for the first time in November 2025. The Commission's own home page, updated in March 2026, states that the compact "has reached activation status; however, compact privileges are not yet being issued". Its March 2026 update said it was "currently adopting rules and bylaws" and "developing the process for creating a shared data system", and issued a request for proposals for that system with responses due April 6, 2026.

The rulemaking had not finished by September 2026. The Rules Committee's minutes of August 20, 2026, list the "Draft Rule on Compact Privilege Process" at discussion stage and record that residency verification "is not a current feature" of the data system. Its agenda for September 17, 2026, still carries the draft rule on obtaining a new home-state license for discussion. The Commission's original timeline gave "approximately 18-24 months" from activation before dietitians could apply, a window that opens in September 2026 and closes in March 2027; its home page now says "around 12 to 24 months".

What a privilege will require is settled by the model legislation every enacting state adopted: the right to use the term Registered Dietitian, or the equivalent education, supervised practice and examination; an active, unencumbered license in the dietitian's home state; fees; a jurisprudence requirement where the remote state has one; and a background check. The compact's definition of dietetic practice expressly includes services "in person or via telehealth", and a privilege holder "shall adhere to the laws and regulations of the Remote State".

Which states have joined the Dietitian Licensure Compact?

Nineteen, on the Commission's own map as of July 2026, and four of them enacted it in 2026. Georgia's compact article arrived inside the bill that rewrote its whole practice act. Kentucky's took effect on July 15, 2026, through a chapter of the 2026 Acts, not the bill the Commission's dataset cites, which died in committee. Missouri's took effect on August 28, 2026, and Washington's, signed in March 2026, takes effect on July 1, 2028. Alaska and West Virginia have bills pending, and South Carolina's bill passed its Senate in February 2026, which the Commission's dataset had not yet recorded. Fifteen states had seated a commissioner as of the January 2026 roster.

California, Texas, Florida, New York, Pennsylvania, Illinois, North Carolina, Michigan, New Jersey, Massachusetts, Virginia, Colorado, Arizona and Minnesota have not enacted it. North Carolina's board says so on its own site, adding that "the compact is not functioning yet". Four of those states could not join on the compact's own terms even if they wished: a state must license the practice or the listed titles to be a member, and Arizona, California, Colorado and Virginia issue no credential. The Commission's 2023 toolkit also listed Michigan, which has since created a license and so is no longer barred by that reasoning.

A license from another state does not make a dietitian in a non-licensing state eligible either. Under the model act a "Single State License" granted to a dietitian who lives in a non-licensing state "shall not be recognized as granting a Compact Privilege" anywhere else, and the Commission's toolkit spells it out: a dietitian who lives in a state without licensure "would not be eligible to access the compact because they would not hold a license from their Home State". A California-resident practice will be applying for single-state licenses for the foreseeable future, compact or no compact.

Dietitian Licensure Compact status by state, from the Commission's map dataset and the enacting legislatures, as of September 2026.
Status	States
Enacted, activating states (March 21, 2025)	Alabama, Mississippi, Nebraska, North Dakota, Ohio, South Dakota, Tennessee
Enacted, 2025	Arkansas, Iowa, Kansas, Montana, Oklahoma, Rhode Island, Utah, Wisconsin
Enacted, 2026	Georgia, Kentucky (effective July 15, 2026), Missouri (effective August 28, 2026), Washington (effective July 1, 2028)
Pending or passed one chamber	Alaska, West Virginia, South Carolina
Not enacted, and ineligible while they issue no license	Arizona, California, Colorado, Virginia
Not enacted, no active legislation	The remaining states, including Texas, Florida, New York, Pennsylvania, Illinois, North Carolina, Michigan and New Jersey

Do I need a license in the state where my telehealth client is located?

Where the state reserves the practice, yes, and several say it in terms. North Carolina's board rule deems "any person, whether residing in this State or not" who delivers medical nutrition therapy electronically to a client located in North Carolina to be practicing there. Iowa's board rule states that "any licensee who provides a telehealth visit to an individual or a group located in Iowa shall be licensed in Iowa". Illinois writes telepractice into its act and subjects telepractitioners to all of its licensing provisions. Maryland's regulations require a telehealth practitioner to be "licensed in Maryland when providing telehealth services to a patient located in the State". Alabama's board answers the question directly: "You cannot use your out-of-state license to practice in Alabama." The District of Columbia has the most explicit rule of all: an unlicensed practitioner may not deliver telehealth to a client physically in the District unless an existing relationship exists and either the client is temporarily present or is a resident and the services do not exceed 120 days.

Two practice-exclusive states add narrow exemptions for out-of-state practitioners. Georgia exempts a licensed or certified dietitian elsewhere who serves a patient "temporarily located in this state", defined as not more than 90 days in any twelve months, or provides short-term continuity of care, or consults with a Georgia-licensed practitioner who holds the relationship. Montana's carve-outs are similar and each requires the out-of-state practitioner to consent to the board's jurisdiction. A new Montana-resident client fits none of them. North Dakota allows up to 30 days a year of limited practice on prior written application and a $25 fee, and Wyoming allows a non-resident dietitian licensed in a state with at least as stringent requirements up to 20 days a year.

Where the state protects only a title, a license is needed to use the title but not to counsel. Texas is explicit: no Texas license is required to practice dietetics with a Texas client in person or by telehealth, but a dietitian who represents themselves to that client as a “licensed dietitian” or “LD” must hold one. New York’s certification, Washington’s and Utah’s certifications, and the title-only licenses in New Hampshire, Oklahoma, Oregon, South Carolina and Massachusetts work the same way. Idaho and Indiana are title-only states with general telehealth statutes that deem care to occur where the patient is; how those bind a profession regulated by title alone is unaddressed in either state. Pennsylvania is unresolved: its Department of State’s telemedicine FAQ says any practitioner serving a person located in Pennsylvania needs a Pennsylvania license, while its dietetics statute prohibits only holding out as a licensed dietitian-nutritionist. California, Virginia, Colorado and Arizona have no credential to require, though California’s title rules and posted-notice requirement and Colorado’s consumer-protection title rule attach to the practice wherever it sits. A remote client’s state can also reach the practice’s records: Texas’s medical-records-privacy chapter and Washington’s consumer-health-data act both apply to a practice outside HIPAA, as set out in which privacy law reaches a US dietitian.

What a dietitian licensed elsewhere needs to serve a client located in the state, by telehealth, as of September 2026. Practice-exclusive states are listed first; title-only and no-credential states impose no practice bar unless a separate telehealth statute does, as in West Virginia.
State	License needed for a remote client?	Alternative or exemption
District of Columbia	Yes, most explicit rule	Existing relationship and client temporarily present, or resident for no more than 120 days
North Carolina	Yes for MNT; anyone delivering it electronically is deemed practicing in NC	None
Iowa	Yes, by board rule	None
Illinois	Yes for MNT; telepractice is inside the Act	None
Maryland	Yes, by regulation	None
Alabama	Yes; the board says an out-of-state license cannot be used	Compact privilege once live
Georgia	Yes for MNT	Client temporarily present up to 90 days in 12 months; short-term continuity; consultation with a Georgia licensee
Montana	Yes for MNT	Three narrow carve-outs, each requiring consent to board jurisdiction; not a new resident client
North Dakota	Yes	Continuation of a home-state relationship; up to 30 days a year on written application and a $25 fee
Florida	Yes, or register	Out-of-state telehealth registration: liability coverage required, no Florida office, no in-person care
Delaware	Yes, or register	Interstate telehealth registration from the Division of Professional Regulation, $50
Vermont	Certification protects the title only	Interim Telehealth Registration offered for out-of-state practitioners
West Virginia	Title only, but interstate telehealth registration statute names the dietitian article	Registration
Wyoming	Ambiguous	Non-resident dietitian up to 20 days a year
Louisiana	Yes	Non-resident dietitian 5 days, or 30 days a year if licensed in a substantially equal state
Michigan	Not until about October 2027	Telehealth rule binds licensees only; no out-of-state pathway
Texas	No, unless "licensed dietitian" or "LD" is used with the client	Not needed
Pennsylvania	Unresolved: DOS says yes, the statute protects only the title	None
New York, Washington, Utah, Wisconsin, Connecticut	No; certification protects the title only	Not needed
New Hampshire, Oklahoma, Oregon, South Carolina, Massachusetts, Alaska	No; the license protects the title only	Not needed
Idaho, Indiana	Title only, but a general telehealth statute deems care to occur where the patient is; interaction unresolved	None published
California, Virginia, Colorado, Arizona	No credential exists to require	California title rules and posted notice, and Colorado's title rule, still apply

Which states offer a telehealth registration instead of a full license?

Three states run a registration a dietitian can use: Florida, Delaware and Vermont, each structured differently. Two more, West Virginia and Arizona, have a registration statute with no confirmed process for dietitians. West Virginia’s interstate telehealth statute requires a registration and names the dietitian article, but its board’s process could not be verified. Florida's is the clearest. Because the dietetics part of chapter 468 is named in its telehealth-provider definition, an out-of-state dietitian may register as an out-of-state telehealth provider rather than obtain a Florida license. A registrant "may not open an office in this state and may not provide in-person health care services to patients located in this state", must "maintain professional liability coverage or financial responsibility" covering telehealth to patients outside the home state, and on the Department of Health's form attests to at least $100,000 per claim and $300,000 aggregate. The Department publishes each registrant's malpractice carrier and policy limits.

Delaware requires a provider licensed in a state that has not adopted an interstate compact to obtain an interstate telehealth registration from its Division of Professional Regulation before providing telehealth, and the Division runs a dietitian-specific one at $50. Vermont's Office of Professional Regulation offers an Interim Telehealth Registration for a professional "who does not hold an active, conventional Vermont license and who is providing healthcare in Vermont via telehealth", and links to it from its dietitians page. Arizona has an interstate telehealth registration statute administered by "each applicable health care provider regulatory board", and since no dietetics board exists there is nothing to register with. The statute in any case excuses providers with fewer than ten telehealth encounters a year.

Once a state license is in hand, whether the client’s insurer pays for the session is a separate question, starting with whether Medicare pays for a telehealth nutrition visit. The full state-by-state map of what each state regulates is in licensure and protected titles by state. The other decisions that change by state, from licensure to sales tax, are mapped in starting a dietitian private practice in the US.

Put it into practice

Starting a dietitian private practice in the USLicensure, privacy, records, billing, entity and tax: the other decisions that change by state.Licensure and protected titles by stateAll fifty states and DC: what is regulated, which words are protected, what an unlicensed person may sell.Do Canadian dietitians need to register in another province?Whether a Canadian dietitian must register in another province to see clients there.

Frequently asked questions

Can a registered dietitian use the Dietitian Licensure Compact to practice in other states?

Not yet. As of September 2026 the compact is enacted in nineteen states and has reached activation, but the Compact Commission states that "compact privileges are not yet being issued". Its Rules Committee was still discussing the draft compact-privilege rule in August 2026, and the shared data system was out to tender in March 2026. The Commission's own estimate was 18 to 24 months from its March 2025 activation before dietitians could apply, a window that opens in September 2026 and closes in March 2027; its home page now says 12 to 24 months.

Which states are in the Dietitian Licensure Compact?

Nineteen as of the Commission's July 2026 map: Alabama, Arkansas, Georgia, Iowa, Kansas, Kentucky, Mississippi, Missouri, Montana, Nebraska, North Dakota, Ohio, Oklahoma, Rhode Island, South Dakota, Tennessee, Utah, Washington and Wisconsin. Washington's enactment takes effect on July 1, 2028. Alaska and West Virginia have bills pending, and South Carolina's passed its Senate in February 2026. California, Texas, Florida, New York, Pennsylvania, Illinois and North Carolina have not enacted it.

Can a dietitian in California or Texas use the compact?

A California-resident dietitian cannot, even once the compact is live, because a privilege requires an active license from the dietitian's home state and California issues none; the Commission's 2023 toolkit named Arizona, California, Colorado, Michigan and Virginia as ineligible for that reason, and Michigan has since created a license. A Texas-resident dietitian holds a home-state license but Texas has not enacted the compact, so no privilege is available until it does. A single-state license obtained in another state does not confer a compact privilege in either case.

Does a dietitian need a Texas license to see a Texas client by telehealth?

No, unless the dietitian uses the title "licensed dietitian" or the initials "LD" with that client. The Texas Department of Licensing and Regulation states that individuals are not required to hold a Texas dietitian license to practice dietetics in Texas in person or via telehealth, and that only those who represent themselves as a licensed dietitian to a Texas-located client must hold one. Texas telehealth rules also require consent documentation to be kept for at least five years.

Can an out-of-state dietitian register for telehealth in Florida instead of getting a Florida license?

Yes. Florida's telehealth statute includes dietitians licensed under part X of chapter 468 in its provider definition and offers an out-of-state telehealth provider registration as an alternative to licensure. A registrant may not open a Florida office or see Florida patients in person, must maintain professional liability coverage for telehealth to out-of-state patients, and on the Department of Health's registration form attests to coverage of at least $100,000 per claim and $300,000 aggregate. The Department publishes each registrant's insurer and policy limits.

What does a dietitian need to serve a client in Washington, DC by telehealth?

A DC license, unless a narrow exception applies. The District's health-occupations code, rewritten in 2024, provides that an unlicensed practitioner may not provide a telehealth service to a client physically located in the District unless the practitioner and client have an existing relationship and either the client is temporarily present in the District or is a District resident and the services do not exceed 120 days, or a longer period the Mayor sets by rule. DC licenses the practice, not just the title, and offers a separate nutritionist license through the CNS examination.

References

Published by NutraPlanner. · Last updated 2026-09-25

Licensure & scope

Can a Dietitian See Clients in Another State? The Compact Is Enacted, Not Live