Provider Demographics
NPI:1487726824
Name:PENINGER, MAYA JARIWALA (RD,LDN)
Entity type:Individual
Prefix:
First Name:MAYA
Middle Name:JARIWALA
Last Name:PENINGER
Suffix:
Gender:F
Credentials:RD,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 WOLF CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28711-9770
Mailing Address - Country:US
Mailing Address - Phone:828-275-4251
Mailing Address - Fax:
Practice Address - Street 1:30 WOLF CREEK DR
Practice Address - Street 2:
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28711-9770
Practice Address - Country:US
Practice Address - Phone:828-275-4251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002897133NN1002X, 133V00000X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education