Unpacking Non-Dietitian Nutrition Credentials

January 2025 Issue

Unpacking Non-Dietitian Nutrition Credentials
By Alexandria Hardy, RDN, LDN
Today’s Dietitian
Vol. 27 No. 1 P. 20

How Do They Compare to the RD/RDN?

Nutrition experts abound in today’s culture. Many are high profile individuals on social media, with thousands of followers and firm opinions about the quality, quantity, and composition of the food we eat. But are all their claims validated by their credentials?

While the public may appreciate some of the differences between an RD/RDN and someone without a nutrition background recommending a specific diet, they may not know the difference between an RD/RDN and a certified nutrition specialist or a nutrition educator. As dietitians, it’s an important part of our job to help clearly define our scope of practice to the public and our patients, and to answer basic questions about other nutrition providers. We should be able to differentiate our expertise from the many other licensed or certified providers who offer similar sounding services.

The RD/RDN Credential
There are several different pathways requiring a combination of education and supervision to becoming a dietitian postundergrad. The Graduate Program and Coordinated Program both integrate coursework and at least 1,000 hours of supervised practice to meet RD/RDN eligibility. The Didactic Program + Dietetic Internship (DI) pathway involves completing coursework at the bachelor’s or graduate level, followed by a DI.1 The Foreign Dietitian Education Program + DI provides a route for international graduates, combining dietitian education with a US-based internship.2 Additionally, the Individualized Supervised Practice Pathways (ISPPs) offer flexible supervised practice opportunities, either for individuals who didn’t match with a traditional internship (Standard ISPP) or for those holding a doctorate (Doctorate ISPP). ISPPs allow for more individualized learning compared with other pathways, especially in terms of how and when practice hours are completed.3

The national registration exam is available to all candidates who successfully complete the above requirements and are validated by the Commission on Dietetic Registration (CDR).4 The exam covers four main domains: the principles of dietetics, nutrition care for individuals and groups, management of food and nutrition programs and services, and foodservice systems.4 Additional requirements to maintain the RD/RDN credential include completing 75 CE credits on a five-year cycle for CDR as well as meeting state licensure requirements where relevant. There are also opportunities for dietitians to earn specialized credentials, certificates of training, and professional recognition through CDR.

Updated Requirements
According to the updated CDR guidelines, which went into effect on January 1, 2024, only candidates with a master’s degree are eligible to take the registration exam for dietitians.5 This change was made in response to recommendations from the Council on Future Practice Visioning Report from 2012, as most other health care professions had advanced their entry-level educational standards.6 The graduate requirement for RDs was deemed appropriate based on the necessary abilities and expertise and in 2013 was finalized and agreed upon between Accreditation Council for Education in Nutrition and Dietetics, CDR, Council on Future Practice, the Academy of Nutrition and Dietetics Education Committee, and Nutrition and Dietetics Educators and Preceptors Dietetic Practice Group.6

Undergraduate requirements remain the same, requiring a bachelor’s degree from a board-approved, regionally accredited college or university with a major course of study in nutrition or a closely related field.

Scope and Standards of Practice
The scope and standards of practice for dietitians outline the expertise of the collective profession. They typically encompass everything from education, credentialing, accreditation, CE requirements, state and national regulations, and ethics.7 Areas of focus are similar to those of the internship and include providing food, nutrition, and dietetics services to enhance public health and deliver quality care.7 It’s important to note that though the scope is intended for dietitians of all disciplines, how it manifests will be highly individualized based on the dietitian and their career path and trajectory.7 The CDR clearly outlines the seven standards of practice (SOP) and standards of professional performance (SOPP), which promote ethical, safe, and person-centered dietetics practice, focusing on evidence-based care, improved health outcomes, efficient resource management, quality assurance, transparent business practices, practitioner competence, consistent performance, and professional development. The CDR’s SOP and SOPP are unique to dietitians, though other nutrition professionals may have their own defined areas of activity through their credentialing boards.

A defining feature of the RD scope of practice is the ability to provide MNT. MNT is any individualized nutrition-based assessment and intervention performed by an RD to treat or prevent a variety of health conditions. MNT is crucial for insurance billing and reimbursement purposes as it differs from nutrition education. The Nutrition Care Process, consisting of nutrition assessment/reassessment, diagnosis, intervention, and nutrition monitoring and evaluation, is the stepwise approach to delivering MNT. In contrast, nutrition education involves teaching groups or individuals at any age about a healthy diet; nutrition education is not eligible for consideration as MNT.

Licensure
Most states legally mandate the licensure or certification of their nutrition and dietetic clinicians.8 The purpose of state licensing is to make it easier for consumers to determine who is authorized to provide specific services defined by scope of practice.9 It’s also useful to determine reimbursable services like MNT through insurance.9

Five states offer state-specific certification: Connecticut, Indiana, Utah, Vermont, and Wisconsin. A licensure map is available on CDR and outlines the statutes on a state-by-state basis.10,11 These state-mandated credentials differ from the national CDR credential and are granted by completing state-specific requirements put forth by its licensing board. For example, Pennsylvania only requires licensure for dietitians, but not nutritionists; other professionals who meet the licensing requirements are also permitted to be licensed in the state. This allows nonlicensed nutritionists to practice alongside registered and licensed dietitians.12 Examples of some non-RD nutritionist jobs include public health nutritionists, WIC nutritionist, and a nutrition coordinator or educator; educational requirements for these positions typically call for a background in nutrition but not always a certification or formal credential.

The Debate Over Licensing Non-RD Nutritionists
Individuals in support of licensing non-RD nutritionists argue that increased access to nutrition services is a benefit to consumers, particularly those who are interested in more holistic counseling or health coaching. Critics are opposed because of the potential risks to public health, as some of the similar sounding disciplines lack the rigorous scientific and clinical training dietitians receive. They also raise concerns that there may be confusion amongst consumers in distinguishing between credentials.

Common Non-RD Credentials
Some individuals choose not to become RDs and instead pursue alternate nutrition credentialing. Some of the most well-known certifications that we will explore in further detail include the Certified Nutrition Professional (CNP), Certified Nutrition Specialist (CNS), and Certified Clinical Nutritionist (CCN).

Certified Nutrition Professional
A CNP possesses a minimum of a bachelor’s degree in nutrition or a related field from a nationally accredited college or university or National Association of Nutrition Professionals Holistic Institute. They are required to have completed a mandatory 1,200 supervised practice hours, to hold a professional membership, and to meet requirements for the Board Certification for Holistic Nutrition.13 Their scope of practice centers on how to improve diet and lifestyle through a holistic lens with a focus on biochemical individuality.14 Though they may work in similar settings to an RD, they are not permitted to provide MNT.14

Certified Nutrition Specialist
The CNS is a credential provided by the Board for Certification of Nutrition Specialists.14 Individuals who hold this credential have an advanced degree and 1,000 hours of supervised practice; in some states, they can be licensed as nutritionists and submit for MNT reimbursement.15,16 This allows them to legally practice individualized nutrition counseling; the only seven states where this isnot permitted are Alabama, Iowa, Kansas, Montana, Nebraska, South Dakota, and Tennessee.16 With a similar curriculum, some may argue this is the credential most closely aligned with the RD. Individuals meet supervision requirements through a self-guided, supervised practicum before taking the CNS exam. CE credits are necessary to maintain this credential, and CNSs practice in many of the same fields as RDs, performing similar work in academia, public policy, and the food and health care industries.17

Certified Clinical Nutritionist
The CCN credential serves as an alternate certification route for those pursuing a career in nutrition. CCNs evaluate individuals’ nutritional needs to support normal physiological functions, drawing on an understanding of biochemical principles to assess client histories, health status, and lifestyle habits to foster overall wellness. Unlike the RD credential, the CCN certification does not require a supervised practice component, which means it typically does not meet state licensure requirements for dietetics practice.

Other Nutrition Credentials
There are many other similar-sounding credentials that permit nutrition practice in various ways. For example, nutrition therapy practitioners (NTPs) generally take a holistic approach to food and may focus on functional and integrative nutrition education. Their program length and training tend to be shorter and not accredited; they cannot provide MNT. The health coach certification through the Institute for Integrative Nutrition is an online certification program with a focus on the educational coaching aspect instead of clinical nutrition; health coaches are not able to provide MNT. The holistic nutrition certification through American Fitness Professionals and Associates is an online, six-month, self-paced course.18 This course can be completed by other licensed nutrition professionals, health coaches, personal trainers, or lay individuals; however, some feel it may lack a focus on evidence-based science.18 This is similar to functional nutrition certification available through the Integrative and Functional Nutrition Academy in that they are both open to various health care professionals, including RDs, RNs, MDs, NDs, and PAs. These certifications emphasize functional medicine approaches to nutrition but lack the comprehensive training of the RD path.19 However, the more evidence-based integrative and functional offerings may be a valuable supplement to another professional health care credential, helping bridge the gap between more traditional clinical and holistic care. Individuals who only hold a functional or holistic certification cannot provide MNT.

Compensation
Another potential difference between the education and licensure/credentialing requirements for various nutrition practitioners is the compensation. According to the US Bureau of Labor Statistics, the 2023 median pay for dietitians and nutritionists was $69,680/year, or $33.50/hour.15 This includes RDNs, CNSs, and some other nutritionists. The Academy of Nutrition and Dietetics recently released the highly anticipated 2024 Compensation & Benefits Survey, which surveyed a randomly selected group of 5,652 RDs. They reported a median hourly wage for all dietitians of $37.98, reflecting a 13% increase from 2021.20

Overall, this indicates a positive trend in salary growth for dietitians, highlighting the importance of salary advocacy and encouraging employers to offer competitive wages. Non-RD nutrition professionals may see a wide range of salaries. Some functional nutritionists charge $200 to $300 for an initial assessment, while those working as nutrition educators at a nonprofit or as WIC nutritionists tend to earn between $21 to $26/hour.21,22

Bottom Line
As dietitians, we can maintain authority and clarity in the face of evolving nutrition certifications by staying informed. Our goal is to support other nutrition practitioners within their designated scope while clearly explaining our own scope of practice and differentiating what services we can legally and authoritatively provide to our clients and communities. While many non-RD certifications offer different pathways to nutrition work, the RD/RDN credential remains the gold standard for comprehensive, evidence-based nutrition care.

— Alexandria Hardy, RDN, LDN, is a writer and the owner of Pennsylvania Nutrition Services, an insurance-based private practice located in Lancaster, Pennsylvania.

References
1. 2024 graduate degree requirement - registration eligibility. Commission on Dietetic Registration website. https://www.cdrnet.org/graduatedegree. Accessed September 19, 2024.

2. Why is the degree requirement for registration examination eligibility changing? Commission on Dietetic Registration website. https://www.cdrnet.org/gradegreewhy. Accessed September 19, 2024.

3. Become a registered dietitian nutritionist. Academy of Nutrition and Dietetics website. https://www.eatright.org/become-an-rdn. Accessed September 19, 2024.

4. About accredited programs. Academy of Nutrition and Dietetics website. https://www.eatrightpro.org/acend/accredited-programs/about-accredited-programs. Accessed September 19, 2024.

5. RD exam overview: Commission on Dietetic Registration website. https://www.cdrnet.org/RDExamOverview. Accessed September 19, 2024.

6. 2024 revised 2024 scope and standards of practice for the registered dietitian nutritionist. Commission on Dietetic Registration Scope and Standards of Practice Task Force. https://www.cdrnet.org/scope. Accessed September 19, 2024.

7. RD examination: eligibility requirements. Commission on Dietetic Registration website. https://www.cdrnet.org/RDNeligibility. Accessed September 19, 2024.

8. Practice tips: CDR certification vs state licensure: what is the difference? Commission on Dietetic Registration website. https://www.cdrnet.org/vault/2459/web//45%20Practice%20Tips-%20CDR%20Certification%20vs%20State%20Licensure%20What%20is%20the%20Difference[60].pdf. Updated May 2024. Accessed September 26, 2024.

9. Licensure protects the public. Academy of Nutrition and Dietetics website. https://www.eatrightpro.org/advocacy/licensure/why-licensure. Updated 2024. Accessed September 30, 2024.

10. Registered dietitian certification and licensure. NutritionED website. https://www.nutritioned.org. Accessed September 26, 2024.

11. State licensure. Commission on Dietetic Registration website. https://www.cdrnet.org/LicensureMap. Accessed September 26, 2024.

12. Becoming a licensed or non-licensed nutritionist in Pennsylvania. Become a nutritionist website. https://becomeanutritionist.org/states/becoming-a-licensed-or-non-licensed-nutritionist-in-pennsylvania/. Updated 2024. Accessed September 29, 2024.

13. Which credential is right for me? National Association of Nutrition Professionals website. https://nanp.org/two-credentials-to-choose-from/. Accessed September 30, 2024.

14. Nutrition professionals scope of practice and standard of care. National Association of Nutrition Professionals website. https://nanp.org/scope-of-practice/. Accessed September 30, 2024.

15. Occupational outlook handbook. US Bureau of Labor Statistics website. https://www.bls.gov/ooh/healthcare/dietitians-and-nutritionists.htm. Updated August 29, 2024. Accessed September 30, 2024.

16. CNS state-by-state practice rights. American Nutrition Association website. https://www.theana.org/wp-content/uploads/2024/04/CNS-State-By-State-Practie-Rights_Updated-April-2024.pdf. Updated April 2024. Accessed September 30, 2024.

17. Scope of practice. American Nutrition Association website. https://www.theana.org/wp-content/uploads/2024/04/CNS-Scope-of-Practice_final.pdf. Updated April 2024. Accessed September 30, 2024.

18. Holistic nutritionist certification. American Fitness Professionals and Associates website. Accessed September 20, 2024.

19. 3 types of nutrition certifications you can pursue. University of Bridgeport website. https://www.bridgeport.edu/news/nutrition-certifications/. Updated November 22, 2022. Accessed September 21, 2024.

20. Compensation and benefits survey of the dietetics profession. Academy of Nutrition and Dietetics website. https://www.eatrightpro.org/career/career-resources/compensation-and-benefits-survey-of-the-dietetics-profession. Accessed October 1, 2024.

21. WIC nutritionist salary. ZipRecruiter website. https://www.ziprecruiter.com/Salaries/Wic-Nutritionist-Salary. Updated Accessed October 1, 2024.

22. Nutrition educator salary. Economic research institute website. https://www.erieri.com/salary/job/nutrition-educator/united-states. Accessed October 1, 2024.