Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kelly McKinnie, PA-C

Individual provider Physician Assistant · NPI 1063104107

Kelly McKinnie, PA-C is a Physician Assistant in Sacramento, California. Qualified in 2023, 3 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
3
Licensed in
CA
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

6600 Bruceville Rd
Sacramento, CA 95823-4671
Phone: (916) 688-2030
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA62775 (CA)

Record details

NPI number1063104107
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedMay 25, 2023
Last updated in NPPESMay 25, 2023
Certification dateMay 25, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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