ND after a doctor’s name stands for Doctor of Naturopathy or Doctor of Naturopathic Medicine. It’s a professional doctoral degree earned by naturopathic physicians, who practice a form of medicine focused on identifying root causes of illness and using natural therapies alongside conventional diagnostic tools. In some states, NDs serve as primary care providers who can order lab work, prescribe certain medications, and perform physical exams.
What Naturopathic Doctors Are Trained to Do
Naturopathic doctors complete a four-year, in-residence doctoral program at a school accredited by the Council on Naturopathic Medical Education (CNME). The first two years cover the same foundational sciences taught in conventional medical schools: anatomy, physiology, biochemistry, pathology, microbiology, immunology, neuroscience, and pharmacology. The final two years focus on clinical training under the supervision of licensed practitioners, with a total program requiring more than 4,100 contact hours of instruction, including at least 1,200 hours of hands-on clinical experience.
Where naturopathic training diverges from a conventional MD or DO program is in its additional coursework. ND students study clinical nutrition, botanical medicine, lifestyle counseling, traditional Chinese medicine, hydrotherapy, homeopathy, and mind-body medicine. The goal is to give graduates a toolkit that blends standard diagnostic methods with natural and preventive approaches.
Licensing and Where NDs Can Practice
Not every state recognizes naturopathic doctors as licensed healthcare providers. Currently, 26 U.S. jurisdictions (including the District of Columbia, Puerto Rico, and the U.S. Virgin Islands) have laws regulating NDs. States with licensure include Arizona, California, Colorado, Connecticut, Hawaii, Oregon, Washington, and about 17 others. In states without licensing laws, the ND title may carry no legal weight, and the scope of what someone calling themselves a naturopathic doctor can do varies wildly.
To become licensed, graduates must pass the NPLEX (Naturopathic Physicians Licensing Examinations), a two-part board exam. Part I covers biomedical sciences and is taken after completing the preclinical coursework. Part II tests core clinical knowledge and can only be taken after finishing all graduation requirements. Both parts must be passed within specific time windows to remain valid.
What NDs Can and Cannot Do
This depends almost entirely on which state you’re in. In the most permissive states like Oregon, naturopathic doctors can perform physical exams, diagnose medical conditions, prescribe pharmaceutical drugs, administer immunizations, order and interpret lab tests and imaging (X-rays, MRIs, ultrasounds, CT scans), perform minor surgery, and refer patients to specialists. They participate in healthcare teams and contribute to electronic health records just like other providers.
Prescription authority is one of the biggest variables. Many states allow NDs to prescribe over-the-counter medications and certain prescription drugs like antibiotics, antifungals, and hormones, but prohibit controlled substances. A few states go further. California, for example, permits NDs to prescribe certain controlled substances under supervision. Montana allows prescription hormones, antibiotics, blood thinners, and vaccines. New Hampshire grants authority over a broad range of legend drugs and even some controlled substances like sedatives. Other states limit NDs to natural therapeutic substances such as vitamins, minerals, and botanical preparations.
Licensed ND vs. Traditional Naturopath
This is an important distinction. A licensed naturopathic doctor (ND or NMD) has completed an accredited four-year doctoral program, passed board exams, and holds a state license to diagnose and treat patients. A “traditional naturopath” has no standardized training requirement. Traditional naturopath programs are often completed online or by correspondence, lack accreditation recognized by the U.S. Department of Education, and do not qualify graduates to sit for the NPLEX board exams. Traditional naturopaths are not licensed to diagnose conditions or prescribe any medications.
If you see “ND” after a provider’s name, checking whether they’re licensed in your state is the simplest way to verify their credentials. A licensed ND will typically be listed in your state’s naturopathic medical board registry.
Insurance Coverage for ND Visits
In states where NDs are licensed, many serve as primary care physicians and participate in both private insurance plans and Medicaid. If you’re under 65 and in a state that licenses NDs, your insurance may cover visits. The major gap is Medicare. Naturopathic doctors are not currently recognized as Medicare providers, so patients who turn 65 or become eligible through disability lose coverage for ND visits. They either pay out of pocket or switch to a different provider. Advocacy efforts to include NDs in Medicare are ongoing but haven’t succeeded yet.
How ND Differs From MD and DO
All three are doctoral-level medical degrees with overlapping foundational science training, but they differ in philosophy and scope. MDs (Doctors of Medicine) and DOs (Doctors of Osteopathic Medicine) have full prescribing authority, can perform major surgery, and practice in hospitals without restriction in every state. NDs have a more limited and state-dependent scope of practice, with a clinical emphasis on prevention, nutrition, and minimally invasive therapies before escalating to pharmaceuticals or procedures.
Naturopathic medicine is guided by a set of core principles: supporting the body’s inherent healing processes, identifying and treating root causes rather than suppressing symptoms, and using the least invasive intervention necessary. In practice, this often means an ND will spend more time on dietary changes, stress management, and lifestyle modifications as first-line treatments, turning to prescription drugs when those approaches aren’t sufficient.