Dietitian Licensing and Certification

As the American public continues to gain an understanding of the importance of good nutrition, the practice of dietetics—and the number of people in the field—is rapidly on the rise. This is a good thing. After all, as the Academy of Nutrition and Dietetics explains, what we consume is among the key contributors to illness and wellness, and increasing access to dietitians can have an exponential impact on people’s lives. As you explore career and education options as a dietitian, it’s important not only to understand the education you need, but also the licensing and certification required to work with the title of dietitian.
“Dietitians play a critical role in delivering medical nutrition therapy to prevent or manage [diseases such as] Type 2 diabetes,” says Academy spokesperson Vandana Sheth. “Dietitians are uniquely educated and have the training to provide individualized care based on a person’s needs, abilities, and resources.”
However, Not everyone claiming to be a dietitian actually has that education and experience. Some people are “exploiting this newly recognized market,” the Academy reports. “Some individuals are not qualified because they lack the objective accredited education, experience, and examination demonstrating their competency to provide services.” It’s something that gets even more confusing when you try to decode the difference between a nutritionist and a dietitian.
State regulations can give consumers confidence that they’re protected against unsafe or inaccurate nutrition advice.
This is where state regulations come in. To ensure consumer safety, the majority of U.S. states have imposed regulations in some form on the field of dietetics. By requiring professionals to prove their knowledge, skill set, and that they have met a set of standards, these laws can help give you a clear path to the necessary education and licensing requirements to work in your state. And in turn, as the Academy of Nutrition and Dietetics reports, that gives consumers the confidence they’re protected against unsafe or inaccurate nutrition advice or interventions that may lead to poor or even dangerous health outcomes—and unnecessary, expensive products and services.
But before we get into the laws of each state, it’s important to first understand the different levels of credentialing states offer—and that, ultimately, to practice as a dietitian, you must meet criteria accepted by the professional community.
Decoding the Dietitian Credentials
Dietitian, Registered Dietitian, Registered Dietitian/Nutritionist—what exactly do all the titles mean and who can use them? To earn your license or certification and legally practice with certain titles, most states require you meet the registration criteria for the Academy’s Commission on Dietetic Registration (CDR), in addition to other state requirements.
A primer:
Dietitian
A person trained in the science of nutrition and dietetics (food science). Many people who don’t fulfill the requirements of a registered dietitian end up working as a dietitian technician.
Registered Dietitian (RD)
A dietitian who has passed the national registration exam.
Registered Dietitian Nutritionist (RDN)
An RD who prefers to use also highlight their nutritional expertise. Formerly just the Registered Dietitian (RD) credential, the CDR recently enacted the Registered Dietitian Nutritionist (RDN) credential for professionals who wish to communicate a broader understanding of nutritional wellness as well as medical nutrition therapy. Using this title is optional but has the same requirements as those for the RD.
Note: RD and RDN: These credentials have identical meanings.
Nutritionist
A person trained in nutrition, but not necessarily in dietetics.
Keep in mind that these credentials are not the same as an optional certification through a specialty board or private association—something that shows deeper study in a particular area, but we’ll touch more on that later. (And when in doubt regarding how this all relates to nutritionists, remember the unofficial mantra of the Academy of Nutrition and Dietetics: All registered dietitians are nutritionists, but not all nutritionists are registered dietitians.)
Licensing, Certification, and Title Protection
State regulations for dietitians typically come with three basic levels of consumer protection: licensing, certification, and title protection. In general, holding a license legally allows you to promote yourself with the title dietitian and provide services within the scope of practice that’s defined by your state. A license verifies that you’ve completed the appropriate education and experience, have agreed to uphold a strict code of ethics, and will adhere to the established standards of the profession.
Licensing allows you to legally use the title of dietitian and provide services within the profession’s scope of practice.
Similar to a license, state certification requires specific education and experience, grants the legal use of the title, and binds you to the standards and ethics of the profession. However, unlike with most licensing laws, there isn’t an included provision known as “practice exclusivity.” In states that offer certification instead of a license, uncertified individuals can practice dietetics regardless of their education or experience, just as long as they don’t promote themselves with any protected title (such as registered dietitian) or otherwise imply that they’ve been vetted by the board. For this reason, consumers should be cautious of receiving services from uncertified individuals and, if unsure, should verify a practitioner’s credentials with the board.
To make things even more confusing, there’s also what’s known as title protection, which is the least protective level of regulation. This law ensures that only individuals who meet certain criteria can call themselves dietitians, but the state doesn’t regulate the ethics or standards of practice, even for titled practitioners. As with certification, title protection means that anyone can legally practice dietetics without a legal credential.
How to Earn the Title of Registered Dietitian (RD) or Registered Dietitian/Nutritionist (RDN)
Regardless of which state you are in, to meet the CDR registration requirements and to practice with the title of Registered Dietitian or Registered Dietitian/Nutritionist, you must complete the following:
STEP 1:
Earn at least a bachelor’s degree from a regionally accredited college or university, with the completion of a program approved by the Accreditation Council for Education in Nutrition and Dietetics (ACEND)
Note: Beginning January 1, 2024, eligible candidates will be required to have a graduate degree to sit for the CDR Examination. This change will not affect those who are currently registered dietitians. Any RD who loses their registration will only need to retake the exam in order to reinstate their status.
STEP 2:
Complete a minimum of 1,200 hours of supervised practice in one of the following:
Note: Most state boards list a requirement of 900 supervised hours. However, to be eligible for the CDR Examination, you must complete the specified 1,200 hours.
STEP 3:
Pass the Commission on Dietetic Registration Examination with a scaled score of at least 25 out of 50
Dietetic Registration Exam Pass Rate
Since 2017, an average of 71% of test-takers have passed the Commission on Dietetic Registration Exam on the first attempt
State Dietitian Requirements
As of 2020, 41 states and Washington, D.C. require the licensing or certification of dietitians or dietitian/nutritionists. Each state bestows a specific title—typically certified dietitian or licensed dietitian upon meeting all requirements. (Some states offer separate licensing for dietitians and nutritionists, while others have a dual credential that allows you to use either or both titles as you wish.) Remember, though, that as part of the licensing or certification process, most states require fulfillment of the standard criteria for CDR requirements.
In states that only offer certification, uncertified individuals can practice dietetics as long as they don’t promote themselves with any protected title.
However, in place of CDR requirements, some states accept the criteria for the Certified Nutrition Specialist (CNS) credential from the American Nutrition Association. Earning CNS certification requires at least a master’s degree and a passing score on a different exam, but only 1,000 hours of supervised experience. But keep in mind, this doesn’t allow you to use the title of registered dietitian.
Find your state below to learn about the level of credentialing it offers, what the requirements are, and how much continuing education you need to keep your license or certification current.
Dietitian Specialty Certification
Beyond any requirements of your state, you can also choose to pursue voluntary certification through a national credentialing agency. Additional certifications demonstrate that you have expertise and experience beyond entry-level requirements, are likely specializing in a specific area, and are dedicated to staying up to date on the latest advancements in the field.
Keep in mind that in states without certain legal requirements, “anyone without formal education or experience could practice nutrition in some from,” says Corinne Bush, the American Nutrition Association’s (ANA) director of nutrition science and education. If this applies to where you live, earning optional certification is especially recommended. These credentials can not only boost your competitiveness when searching for jobs, but also help guide you into leadership positions and increase your earning potential.
If you earned a state credential then you’ll likely already be certified as an RD with the CDR or as a CNS through the ANA’s Board for Certification of Nutrition Specialists (BCNS). Both of these associations offer additional certifications in specialty areas of dietetics and nutrition.
The CDR has seven specialist certifications:
To earn any of these certifications, you must have been holding current RD status for at least the two previous years, have 2,000 hours of practice experience in the specialty area in within the last five years, and pass the appropriate exam. To maintain certification, you’ll need to provide documentation for another 2,000 hours of specialty experience and retake the exam every five years.
The (BCNS) also offers the Certified Ketogenic Nutrition Specialist credential for professionals who want to gain deeper knowledge of how the metabolic process of ketosis can be used to treat conditions such as epilepsy, diabetes, or Alzheimer’s disease. To earn this credential, you must: