How to Start Your Nutrition Private Practice

Introduction

It was almost four years ago now that I started my private practice, Your Kidney Dietitian. How time flies!

When I started my practice, I had a TON of questions about what to do and how to do it. We didn’t learn this stuff in school, of course. I spent a lot of time reading blog posts, Facebook groups, and even joined an expensive business coaching program because at the time I felt it was a necessity.

If you’re interested in starting your own practice, don’t feel like your only option is investing $10K in a coaching program. You can figure this out! But there are some specific steps you need to follow and some decisions you need to make about your business model. In this article I aim to guide you through the process and hopefully help you feel a little less overwhelmed.

Decisions to Make When Starting A Private Practice

Before diving into all the nitty gritty, there are a few decisions you should consider about how you want to run your business. Keep in mind, these choices can always change if you get started and find it’s not working the way you’d hoped.

Insurance or Cash Pay

Consider whether you want to take insurance or start a cash pay business. There are pros and cons to both.

Cash Pay Practice Pros and Cons

Cash pay is nice because the money for services provided is in your pocket right away. You also have the freedom to package services and charge however you like. I primarily offered cash pay services when I started my practice. However, in 2025’s economy it seems to be getting harder to sell these types of services, especially when all major insurance plans cover MNT these days.

Insurance Based Practice Pros and Cons

Accepting insurance is another option. I’ve found it much easier to get new patients in the door since starting to accept insurance! People are already paying for it, and they are eager to use their benefits. While insurance may seem like a headache to navigate, I promise it’s not that bad. I’ve been referring lots of people to The Dietitian Mentor page on Instagram for guidance on how to apply for credentialing with the major insurers. The process isn’t hard, just time consuming.

In terms of actually submitting claims, that process is pretty simple as well. If you plan to bill insurance, you may want to take that into account in selection of your EMR. I previously wrote a post about how easy it is to bill insurance via my EMR, Practice Better.

Timeline for getting paid varies depending on what insurance you’re billing. Payment can be as quick as 1 day or as long as 1 month, in my experience. Occasionally I run into denied and rejected claims, but 95% of my claims process without issue.

Both Insurance and Cash-Pay

Personally I offer a mix of insurance based and cash-pay services in my practice. While the majority of my income comes from insurance payments these days, it’s nice to be able to offer add on services like meal plans and courses, as well as serve people whose insurance doesn’t cover MNT. (For these patients I offer an equitable pricing model – read more about it here.)

Virtual or In-Person

Do you want to open up a brick and mortar practice in your neighborhood? Or do you plan to work remotely and offer telehealth appointments? This can depend on various factors, such as what patient population you serve.

As a dietitian who works with patients with CKD, my practice is primarily telehealth-based, so I can serve patients who don’t have access to an RD in their geographic area. As such, I’ve obtained my dietitian licensure in numerous states beyond my home state.

I do have some patients who prefer to meet in person, but it’s not the bulk of my patient load. For this reason, I rent office space by the hour versus monthly rental of an entire office space. Another option might be renting office space several days per week or month from another healthcare provider, such as a therapist or doctor.

My suggestion is to start as a virtual practice to minimize your business expenses, then explore opening a physical office if there’s the demand for it.

Individual or Group Practice

I’m guessing that most RDs start their private practice as a solo provider. Some people (like me) don’t have an interest in expanding the practice and hiring additional dietitians. That’s totally fine.

But if you know you DO want to grow to a group practice (or it’s as door you want to leave open as a possibility) you should take this into account – it can come into play with the way you set up your insurance contracts, which EMR you choose, etc.

Because I don’t have a group practice myself, I’m not going to offer more specific guidance here. However, there are other RDs out there offering support in this area if you need it.

The Boring But Important Stuff

You’ve decided on some basics about how you’ll run your business. But before announcing you’re open for business, there are a few important things to take care of.

Form Your Business Structure

Even if you’re a solo practitioner, you should separate your business from yourself by creating a business structure such as an LLC, PLLC, S-Corp. You should speak with a lawyer to determine the requirements in your state, and/or an accountant to determine what business structure is ideal for taxation purposes.

In Illinois, where I live, my business is a PLLC, or professional limited liability corporation. I applied online via the Illinois Secretary of State’s office and paid an application fee of $150. There is also an annual fee to keep my PLLC active. The exact process and steps will vary depending on where you live.

Get A Business Address

Your business should have an address – even if your practice is virtual! Many dietitians with telehealth-based practice don’t rent an office space, and instead will rent a business mailbox from somewhere like Regus (which doesn’t get great reviews, but it’s a common one).

If you’re taking insurance, this address should be a place where you can theoretically see patients, so this means you cannot just use a P.O. Box at the post office for your business address.

I rent a mailbox a local co-working space for $75/month. My subscription also allows me to rent conference rooms by the hour if I have patients who want to meet in person (as mentioned previously).

Get an EIN for Your Business

An EIN is essentially a social security number for your business. It’s free and easy to apply for an EIN online via the IRS website. If you don’t have an EIN, you’d need to use your social security number when applying for insurance contracts, submitting insurance claims, or completing tax forms like W-9s. Try to keep your SSN private please! Just get an EIN instead, it’s super easy and will be issued to you almost immediately after applying.

Apply for An NPI number

A National Provider Identification number is a number associated with a healthcare provider or healthcare organization. It is primarily used for insurance billing purposes. You can apply for an NPI number via the NPI Enumerator, or NPPES.

You should get an NPI for yourself — this is a Type 1 NPI or Individual Provider NPI. But you might need one for your business/organization as well — this is a Type 2 NPI or Group/Organizational NPI. If you are going to take insurance, some plans, like Medicare and Aetna, will require you to contract as a “group” meaning you need a type 2 group NPI for your business – even if it’s just you.

Professional Liability Insurance

Professional liability insurance is a must, to protect yourself and your business in the event of a malpractice suit. I use Proliability for my professional liability insurance. I also added general liability insurance to my policy since I see some patients in person.

Begin Insurance Credentialing

If you plan to take insurance, start the process of credentialing right away after getting your LLC, business address, EIN, and NPI number(s). Getting in network with insurance is as simple as completing the necessary paperwork, but it’s a time consuming process, usually about 3 months start to finish.

Again, I recommend Dietitian Mentor on Instagram for tons of great free info on how to get in network with the major insurance providers. The Reimbursement Dietitian is another popular resource about insurance billing for dietitians.

Get a Business Bank Account & Credit Card

It’s good to keep all your business expenses separate from your personal expenses. To keep it simple and streamlined, all of my business related expenses go through one business bank account and one business credit card. I use Novo online bank for my business checking account, and Chase Business Ink for my business credit card.

Tools To Run Your Practice

Next, think about what kind of tools you’d need on a day to day basis in your practice.

Business Email, Phone Number, and Fax Line

Self explanatory, but you need a way for people to get in touch with you. I use Google Voice for my business phone number, Goole Workspace for my business email, and fax.plus for my fax line. Yes, you DO need a fax line if you’re opening a private practice, because this is how most doctor’s office prefer to send labs and referrals. Even in 2025.

Electronic Medical Record (EMR)

I would be lost without my EMR, which allows me to book appointments, send forms, collect insurance information, store documents like labs or referrals, create appointment notes, communicate with patients via chat messenger, and more. My EMR of choice for the last ~4 years is Practice Better.

Payment Processor

Processing credit card payments in your patient portal, such as appointment co-pays? You will most likely need to sign up with a payment processor like Square or Stripe. The payment processor takes a small cut of each credit card payment processed.

Video Conferencing Platform

Telehealth providers will need a HIPPA compliant platform to offer virtual meetings. While my EMR offers a built in video conferencing service, I prefer to use Zoom, which connects to my EMR as a 3rd party integration.

Other Things To Consider

Create A Business Website

While you don’t need to have a website to run a private practice, I strongly recommend having one. Most people expect a businesse to have a website these days where potential clients can learn more about the business and what they offer.

A basic website can be very affordable, but a website can also be a significant investment, depending on what features you’re looking for. I wrote more about the costs associated with running a website here.

Map Out Your Marketing Plan

How do you plan to get new patients in the door? This will likely be an evolving process as you figure out what works best for you! Some different ways you can market your business include:

• Visiting/networking with doctors to solicit referrals
• Networking with therapists or other healthcare providers
• Social media marketing (Instagram, Facebook, TikTok)
• Email marketing
• Website/SEO
• Online directories like HealthProfs.com
• Appearing as a podcast guest

There are MANY ways to market your business – this list is not exhaustive. At Your Kidney Dietitian, most of my new clients find me via my listing in the NKF CKD dietitians directory, referrals from nephrologists, and my website/SEO.

A service like Canva can also be helpful for creating print or digital marketing materials like brochures, business cards, and social media posts.

Get Licensed in Other States

Providers primarily offering telehealth services may want to consider getting licensed in neighboring states to expand their reach. Each state has its own statues are rules regarding licensure. I recommend doing your own research to understand the requirements for each state.

Conclusion

Hopefully by now, you have a better idea of what steps to take to get started building your private practice. If the idea of diving in and starting your own business seems overwhelming, take it from me, I’ve been there. I didn’t think I had an entrepreneurial bone in my bone. But here I am now nearly 4 years later, running not one but two businesses. If I can do it, so can you!

If you’re interested in talking with me about business or private practice related stuff, I offer mentorship services for $75/hr. Feel free to hit me up — I would love to chat and support you on your journey! And if you need web design services, keep me in mind too. You are not alone out there. I can’t wait to see how your business grows.