November 29


What’s In a Name?

By Sunny Brigham, MS, CNS, LDN

November 29, 2016

minutes read time


Today’s blog is an educational one, as mine usually are.  But it’s a different type of education.  We aren’t going to talk about digestion or food.  We are going to address the word “nutritionist.”  I see dietitians make comments about only seeing a dietitian.  And, truthfully, the term nutritionist isn’t a well-regulated term.  So today my friends, I want to make some clarifications on the difference between a dietitian and a nutritionist and go over some common post-nominal letters or designations.

First let’s talk about the Board Certified Nutrition Specialist (CNS)…mainly because I’m slightly partial to this one.  The CNS credential is given to those that can demonstrate a competency as an “advanced clinical nutrition professional.”  Those holding the CNS must have a Master’s of Science degree in Human Clinical Nutrition or higher.  Many MDs, DOs, and researchers can obtain the CNS credential if they wish to add nutrition as a part of their practice or research.  In addition to the degree, you must also obtain 1,000 supervised clinical hours in three main areas: Assessments, Education, and Monitoring (to be brief).  After the degree is obtained and the hours are finished, you must also sit for and pass a credentialing exam.  If you pass, you can then use the CNS post-nominal letters.  If the state allows for licensing, the CNS holder can also become a Licensed Dietitian Nutritionist (LDN).  So…someone with a CNS will look like this:  Jane Doe, MS, CNS or Jane Doe, MS, CNS, LDN.

Let’s talk about a dietitian.  To become some level of a dietitian, you need to have at the minimum an Associates of Science in Dietetics from a school accredited by the Accreditation Council for Education in Nutrition and Dietetics (ACEND). You must then complete a 450 supervised hour clinical rotation in a community based program and pass their national examination.  This will allow you to become a Nutrition and Dietetic Technician, Registered (NDTR).   Your name would look like this: Jane Doe, NDTR or Jane Doe, DTR.  To become a Registered Dietitian Nutritionist (RD or RDN), you must obtain a Bachelor’s of Science in Dietetics from a school ACEND has blessed off on.  You will then need to complete a 1,200 supervised hour clinical rotation and pass a national examination.  All RDs or RDNs are eligible to be licensed or certified in their state, with a few state exceptions like Colorado.  An RD will look like this:  Jane Doe, RDN (or RD).  If they are licensed, it will be Jane Doe, RDN (or RD), LDN.  And if they are certified as opposed to licensed (varies by state), it’ll be Jane Doe, RDN (or RD), CDN.  Now toss in a MS degree in there and you have another purdy post-nominal designation.  Phew…that was a long one.

I’ll discuss the variety of others in a minute, but I want to point a few important things out here.  An RDN or DTR is not required to hold a MS degree; a CNS is.  A CNS or RDN are the only credentials recognized by the US Government authorized to become licensed in their state.  No others can be considered for licensing.  The importance (or lack of importance) for licensing is accepting insurance.  If you’re licensed, you can take insurance.  If you’re not, you can’t.  Simple as that.  Doesn’t make you smarter J  The main difference between the 2 main credentials is how we practice.  You will find RDNs in hospitals, doctor’s offices, or private practice.  It’s rare you will find a CNS in a hospital, but you will in the other 2 locations.

One more I’ll hit on that is just as important at the CNS and the RDN is the Board Certified Clinical Nutritionist (CCN).  In order to obtain the CCN credential, you must have a Bachelor’s of Science degree with a specific set of science and nutrition courses, complete a 56-hour post-graduate program, obtain 900 supervised hours of clinical rotation, and pass a credentialing exam.    For someone that holds a MS in Human Clinical Nutrition, they can sit for the exam, given they have already completed a clinical rotation, and use the CCN designator upon passing.  They will look like this:  Jane Doe, CCN or Jane Doe, MS, CCN.  A CCN cannot be licensed in any state.

Those are the only 4 (CNS, DTR, RDN, and CCN) designators that require a supervised clinical rotation of some sort and are the only ones that can do medical nutrition therapy (state dependent as well).  All the others I will discuss do not require any type of clinical application or experience to obtain the designator; however that does not make them less smart of efficient in what they do.

This article here by the American Nutrition Association (which I am not a part of) breaks it down rather nicely.  The Chicago Tribune did one a few years ago as well.

  • Certified Nutritional Consultant (CNC) – Must pass an open-book exam from the American Association of Nutritional Consultants.  No degree required.
  • Certified Nutritionist (CN) – Must obtain an associate’s degree (non-specific) OR take a 6-week course and pass a proctored exam from the American Health Science University.
  • Certified Holistic Nutritionist (CHN) – Must obtain an Associate’s of Science or higher in nutrition, complete 500 non-supervised hours in direct and indirect contact with clients, and pass an examination.
  • Certified Health Coach (CHC) or Health Coach – Must complete an online, in-residence, or by-mail program to become a health coach (at a minimum…some schools provide MS in heath Coaching).

So…what should you take from this?  Thank you for asking…I was getting tired of typing referenced crap.  Some people feel better knowing they are seeing a nutritionist that has a bunch of fancy letters after their name and some people don’t care.  What matters most at the end of the day is the relationship you build with whatever practitioner you see.

  • Do you trust this person?
  • Do you feel their education level is commensurate with what you’re comfortable with?
  • Do you feel they are connecting with you, truly listening to your needs, and helping you?
  • Are you making progress in the right direction and if not, is it a lack of focus and drive on the part of you or the practitioner?
  • Are they giving you valid answers to questions you’re asking?

Knowing what matters to you the most, how you feel, and what you’re getting from the sessions matters so much more than post-nominal credentials.

Let’s hear from you!  What types of practitioners have you seen and do you feel they were helpful?

  • This is so helpful- thank you! Do you know, if you are a CNS in the state of California, are you technically “licensed” and does that mean you can therefore take insurance?

    • Hi Delaney! That’s a great question and one I don’t know the answer to! Every state is going to be a bit different. Here in Texas, I am not technically licensed but I can take a few insurances. Each insurance policy will have its own guidelines. Sorry I couldn’t give you a better answer! But I do know that as a CNS, you’re wide open to practice in CA!

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