CNS for MDs and DOs

Who Should Obtain the Credential?

MDs and DOs who wish to demonstrate their nutrition specialty with the gold-standard, nationally accredited certification for advanced clinical nutrition professionals.

Education Requirements

The candidate must:

  • Hold a degree from a regionally accredited medical or osteopathy school or foreign equivalent; 

  • Hold a current licensure to practice medicine in the US (or in the country of practice); and

Candidates must also meet each of the following coursework requirements:

  • Nutrition – Minimum of 9 semester credit hours of for-credit coursework or 135 continuing education equivalents (1 semester credit hour = 15 CE equivalents) must be attained in accordance with the following criteria:

    ---Minimum of 4 semester credit hours (or 60 CE equivalents) in foundational nutrition course(s). (Coursework should address Foundational Nutrition Coursework Topics, including fundamental principles of nutrition and the role of nutrients in human health. Online courses and continuing education courses are acceptable.) And

    ---Minimum of 5 semester credit hours in advanced nutrition (or 75 CE equivalents) attained in accordance with one of the following or a combination of the two:

          a. For-credit graduate level nutrition coursework. (Examples of such course topics include, but are not limited to: therapeutic nutrition, nutrition assessment, functional nutrition, nutrient depletion & drug/nutrient interactions, dietary supplements, nutritional disorders) or

         b. Nutrition Professional Continuing Education credits from eligible fellowship or certificate program or other activity, which address CNS Competencies.

  • Biochemistry: Minimum of 6 semester credit hours of for-credit coursework at a regionally accredited university, included in medical school curriculum
  • Clinical and life sciences (including 3 semester credit hours of anatomy/physiology): Minimum of 12 semester credit hours of for-credit coursework at a regionally accredited university, included in medical school curriculum. Examples of such course topics include, but are not limited to biology, micro-biology, chemistry, organic chemistry, botany or biomedical science.

“Regionally accredited” means an institution that was accredited, at the time the degree was awarded, by a regional accreditation body in the United States which is recognized by the Council for Higher Education Accreditation and the United States Department of Education. Degrees from institutions outside the U.S. must be from that country’s equivalent of a regionally accredited U.S. institution.

Experience Requirements

The experience requirement must be completed after academic requirements have been met or while they are in progress. This consists of demonstrated practice in clinical nutrition, as defined by the following: 

  • Completion of 1,000 documented hours of clinical nutrition experience in the following categories:
    ---Nutrition Assessment (200 hours)
    ---Nutrition Intervention, Education, Counseling, and Management (200 hours)
    ---Nutrition Monitoring or Evaluation (200 hours)
    ---Remaining 400 hours may come from any of the above categories or a combination of the categories


Experience may be obtained through:

  • Residency or fellowship in clinical nutrition or part of training in a related subspecialty that incorporates nutrition. Examples may include gastroenterology, endocrinology, critical care, nephrology, cardiology, etc. and/or
  • Clinical practice 

The CNS Practice Experience may be completed after passing the Certification Examination for Nutrition Specialists. However, the candidate will not be awarded, and may not use, the CNS credential until the experience requirement is completed and approved.

Examination Requirement

The candidate must achieve a passing score on the Certification Examination for Nutrition Specialists℠, offered twice a year, typically in the spring and fall.

The examination is designed to test the knowledge and skills acquired by those who have successfully completed both the academic and experiential criteria of the CNS and CNS-S. While we may approve those who have not yet completed the experience requirement to sit for the examination, evidence shows that those with experience perform better than those without.

The examination contains 200 multiple-choice, single answer questions. It covers a broad spectrum of basic and applied nutritional science based on an explicit set of competencies. These have been determined through a job analysis study conducted on practitioners.

The competencies are grouped into domains, subdomains and tasks. As the examination may only assess knowledge pertaining to these competency statements, they serve as the outline, or blueprint for the examination.

See How to Prepare for the Examination and the Examination Content Outline.

Recertification Requirements

To maintain the CNS credential, all CNS certificants must recertify every five years and document 75 Continuing Education (CE) credits. Learn more about recertification.

Application and Required Forms