A naturopathic doctor (ND) holds a real doctoral degree, but is not a medical doctor (MD) or a physician in the medical sense. Licensed NDs complete a four-year accredited naturopathic program and pass national board exams. Unlike MDs, they usually are not required to complete a residency; Utah is an exception. What an ND may do, and what they may call themselves, depends on the state. In New York, NDs are not licensed at all.
ND vs MD at a glance
| Naturopathic doctor (ND) | Medical doctor (MD or DO) | |
|---|---|---|
| Degree | Doctor of Naturopathy or Doctor of Naturopathic Medicine | Doctor of Medicine or Doctor of Osteopathic Medicine |
| School | Four-year doctoral program at a school accredited by the Council on Naturopathic Medical Education (CNME). Seven in North America. | Four-year medical school |
| Entry | Bachelor's degree, or at least three-quarters of the credits. No MCAT. | Bachelor's degree; MCAT typical |
| Clinical training in school | At least 1,200 hours of clinical training, within a program of at least four academic years and 4,100 clock hours | Clinical years in medical school |
| Residency | Optional; required in Utah (12 months) | Required: every state board requires at least one year for a full license, and some require two or three; family medicine board certification requires 36 months |
| Licensing exam | NPLEX Part I and Part II | MDs usually take the USMLE; DOs take COMLEX-USA, which all 50 states accept for DOs (other exam rules vary by state board) |
| Where licensed | 23 states, D.C. and Puerto Rico; banned in 3 states | Every state |
| Prescribing | None to broad, depending on the state | Full, subject to state law |
| Medicare | Not a Medicare physician type | Covered physician type |
Sources: California Board of Naturopathic Medicine, 2026; CNME; CNME Handbook of Accreditation, September 2025; Utah Code 58-71-302; Federation of State Medical Boards; American Board of Family Medicine; AAFP; 42 U.S.C. 1395x. Each is linked in the sections below.
Is a naturopathic doctor a real MD?
No. An ND degree is not an MD degree, and an ND cannot practice as an MD. "Real doctor" is not a legal category. The accurate description is that an ND holds a doctoral degree in naturopathic medicine and, in licensing states, a state license with its own scope of practice.
Be careful with the word "naturopath." NCCIH separates licensed NDs from "traditional naturopaths," who train in non-accredited programs and are not eligible for a license. Everything on this page about four-year programs and board exams applies only to licensed NDs.
Is an ND as good as an MD?
They are not interchangeable, so "as good" depends on what you need.
- Diagnosis, emergencies and serious disease. MDs and DOs complete a required residency, and NDs usually do not. The American Medical Association's main objection to wider ND prescribing is that NDs lack residency training and broad clinical exposure.
- Prescription drugs. An MD can prescribe across the full range of medicines. An ND's prescribing ranges from none to broad, depending on the state (Connecticut OLR, 2023).
- Visit length. Visit length and fees vary by practice. Ask how long the first visit lasts and what it costs before you book.
- Evidence. Studies of naturopathic care are few, and most are small or methodologically weak. A 2019 scoping review found 33 studies, mostly on chronic conditions, that reported benefits. It also included small case series, which weakens that finding.
The doctors' side of this debate is covered in why many doctors are critical of naturopaths. The research is covered in whether naturopathy is legit.
Do naturopathic doctors do residency?
Some do, but for NDs residency is generally optional. A comparison table in a 2025 Wyoming Legislative Service Office memo lists ND residency as optional. The memo credits the table to a 2010 AAFP document that we could not locate. Where NDs do a residency, the Council on Naturopathic Medical Education says the programs are typically one or two years long. Physicians, by contrast, must complete at least one year of postgraduate training for a full license: the Federation of State Medical Boards says all state medical boards require it, and some require two or three years. Family medicine residency typically runs three years (AAFP), and board certification in family medicine requires 36 months of accredited residency.
Utah requires a residency by law. To get a Utah license, an ND must complete 12 months of residency in a recognized program tied to an accredited school, under a licensed preceptor. NDs already licensed in another state may qualify through a separate endorsement route. We did not survey every licensing state, so check your state board if residency matters to you.
Reliable data on how many ND graduates choose a residency is not available. When choosing an ND, ask directly whether they completed one, where, and for how long.
Can an ND call themselves "doctor" or "physician"?
It depends on the state. A July 2025 survey by the Wyoming Legislative Service Office found that 9 states plus D.C. let licensed NDs use "naturopathic physician," while other licensing states forbid the word "physician." The AAFP's position is that NDs should never use the title "physician".
| Rule | Examples |
|---|---|
| "Naturopathic physician" allowed for licensees | Arizona, Montana, Oregon, Utah, Vermont, Washington, D.C.; Hawaii only with an ND identifier |
| "Physician" barred for licensees | Kansas, Maine, Maryland (unless also an MD), Massachusetts (G.L. c. 112, s. 273; titles such as "naturopathic doctor" and "naturopathic physician" are reserved for licensees, but licensees may not use "physician"), Minnesota, New Mexico, North Dakota |
| "Dr." or "Doctor" allowed for licensees (some states require an ND identifier) | Alaska ("doctor of naturopathic medicine"), California ("Dr." must be followed by an ND identifier), Kansas, Montana |
| Using an ND title without a license is a crime | Florida (third-degree felony) |
| No title protection | New York and other unregulated states |
Source for the rows above, unless linked: Wyoming LSO, July 2025.
In New York, the sponsor memo for the 2026 licensing bill S8714 notes that because the state does not regulate NDs, "anyone may lay claim to the title." That bill and a similar Assembly bill, A10064, were referred to committee in January 2026, with no further action found. A New York practitioner who calls themselves an ND holds no New York ND license.
Can an ND be your primary care provider?
Usually not in the full sense. It depends heavily on the state and on your insurer:
- No blanket status. We found no source granting NDs general primary care status. The AAFP says NDs should not be considered primary care physicians.
- New Mexico limits licensed NDs to primary care, practiced in collaboration with a physician (NM Naturopathic Doctors' Practice Act, 61-12G-6).
- Oregon requires insurers to let an ND apply to be credentialed as a primary care or specialty care provider (ORS 743B.407).
- Vermont requires private plans to cover medically necessary care from in-state licensed NDs for services the plan already covers. A plan may pay those visits at out-of-network primary care rates.
- Medicare does not recognize NDs as physicians, so it won't pay for an ND as your doctor (42 U.S.C. 1395x).
- New York has no ND license (naturopathy is not on the state's list of licensed professions), so an ND cannot serve as a licensed primary care provider there.
A practical approach is to keep a medical primary care clinician, such as an MD, DO or nurse practitioner, and see an ND alongside them.
Where NDs are licensed, and what they can prescribe
By our count, 23 states plus D.C. and Puerto Rico license or register NDs (Connecticut OLR, 2023; Wyoming LSO, 2025). The AMA's count is at least 24 states plus D.C. Florida, South Carolina and Tennessee ban naturopathic practice. The other 24 states, including New York, don't regulate it. See which states license naturopathic doctors for the full list.
Prescribing rights vary even more. Connecticut and Alaska give NDs no prescriptive authority, while Oregon and Arizona allow broad formularies (Connecticut OLR, 2023). North Dakota NDs can prescribe prescription drugs only with a board endorsement, which requires a collaborative agreement with a supervising physician and a pharmacology exam, and cannot prescribe controlled substances other than testosterone (NDCC 43-58-08 and 43-58-08.1). See which states let naturopathic doctors prescribe.
How to check an ND's credentials
- Ask for the degree and school. The school should be CNME-accredited. CNME does not accredit fully online programs.
- Ask whether they passed NPLEX. Part II, the clinical exam, cannot be waived (California board, 2026).
- Look up the license. In a licensing state, search the state naturopathic board. In New York, use the NYSED license verification search to check any license the person holds, such as MD, DO, NP or RN.
- Ask about residency. Ask whether they completed one, and where.
- Ask how they work with your doctor. A good answer includes sharing visit notes and lab results.
Our guide on how to find and vet a naturopathic doctor has more questions to ask. When you're ready to compare, browse naturopathic doctors in our directory or naturopathic doctors in New York.
When to see an MD or DO instead
- Emergencies, and any new, severe or fast-worsening symptoms.
- Conditions that need a prescription drug an ND can't prescribe in your state.
- Surgery, hospital care and specialist care.
- Care you want Medicare to cover.
- Before stopping or changing a prescribed medication.
Last reviewed: October 2026