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Our certifying board, the Board for Certification of Nutrition SpecialistsSM (BCNSSM), sets the standard for advanced personalized nutrition practitioners via our Certified Nutrition Specialist® (CNS®) credential.

We certify practitioners in specialty areas of advanced personalized nutrition.

We designate as Fellows those who have distinguished themselves in the area of nutrition science and research.

We partner with universities to instill curriculum standards that equip the next generation of nutrition professionals.



The CNS designation demonstrates to colleagues, clients, employers and the public at large that certified individuals have the knowledge and proficiency required of the professional nutrition practice. BCNS has established qualifying pathways for Nutritionists, APRNs, DCs, DDSs, NDs, PAs, PharmDs, MDs, DOs, and other advanced-degreed health professionals who wish to demonstrate competence as advanced clinical nutrition professionals and/or obtain a potential pathway to state licensure for nutrition practice and Medical Nutrition Therapy. The Certified Nutrition Specialist (CNS) is formal recognition for nutrition professionals who have met rigorous and demanding eligibility requirements, including postgraduate education, subsequent supervised practice in professional nutrition and demonstration of a depth and breadth of knowledge appropriate for effective practice in the profession of nutrition.



The BCNS paper and pencil examination contains 200 multiple-choice, single answer questions, and will cover the broad spectrum of basic and applied nutritional science. Themes such as fundamental principles on nutrition, nutrients and human health, nutrition exam, clinical intervention and monitoring, professional issues, epidemiology, biochemistry and integration of these areas, are threaded throughout the examination. Detailed information may be found within the published Exam Content Outline. Candidates have four hours to complete the examination.



BCNS complies with the Americans with Disabilities Act (ADA) and will provide reasonable and appropriate testing accommodations for candidates with documented disabilities who request and demonstrate the need for accommodation as required by law. BCNS requires verifiable documentation to ensure the individual qualifies under the ADA as a disabled individual, and to allow accommodations to be specifically matched with the identified functional limitation to provide equal access to all testing functions.



The information provided by candidates and any documentation regarding such disability and special accommodation, will be treated with strict confidentiality and will not be shared with any source, with the exception of BCNS authorized testing consultants and proctors, without the candidates express written permission.



Candidates requiring special accommodations must complete the Special Accommodations Request form, and the Documentation of Disability-Related Needs form before scheduling the examination. These forms must be submitted with the CNS or CNS-S Certification Application to the BCNS by the deadline posted on the BCNS website. Arrangements for special accommodations may take up to 45 days to coordinate.



Requests for accommodations are reviewed by the Executive Administrator to ensure the request can be processed without jeopardizing the integrity or security of the examination. The Executive Administrator, or staff designee, will personally communicate with the candidate to ensure all processes and procedures are explained and that a testing appointment is scheduled to accommodate their needs accordingly, if feasible.

On Exam Day

Testing Sites

BCNS examinations are administered at testing sites located throughout the Unites States. Testing sites have been selected to provide accessibility to the most candidates in the most controlled, secure and consistent environments possible. To ensure that examination results for all candidates are earned under comparable conditions and represent fair and accurate



• Failure to adhere to testing site examination restrictions

• Creating a disturbance, being abusive or being otherwise uncooperative

• Bringing restricted materials into the testingarea

• Using electronic communication equipment such as cellular phones, PDAs or communicating calculators.

• Gaining unauthorized admission into the examination testing area

• Attempting to take the examination for another individual

• Recording or attempting to record examination questions or making notes

• Eating and smoking


COMPLETE TOPIC LIST:
Domain I: Principles of Nutrition (13% of exam)

- Practical application of evidenced based research
- Physiology of the digestive tract
- motility
- absorption
- secretion
- intestinal barrier function
- Digestion, absorption, and transport of macronutrients and micronutrients
- Inflammatory pathways including insulin, oxidative stress, and fatty acid oxidation
- Effect of microbiome on metabolism of macronutrients and micronutrients, including use of probiotics and prebiotics
- Nutritional considerations related to physiologic changes associated with life cycle stage
- Effect of microbiome on body composition and metabolism
- Tailoring of exam and therapy specific to life cycle stage
- Nutritional considerations related to psychological and social factors associated with life cycle stage
- Effects of age, gender, and physical activity on body composition and energy expenditure
- Disease risk and prevalence related to socioeconomic status, geographic residency, ethnicity, and life cycle stage
- Regulation of fluid, electrolyte, and acid-base balance
- Basic understanding of nutritional genomics research in practice
- Calculation of individual caloric requirements
- Estimation of caloric values of specific meals

Domain II: Nutritional Biochemistry (12% of exam)

- Nutritional considerations related to psychological and social factors associated with life cycle stage
- Metabolism (biochemical pathways and reactions) of carbohydrates, lipids, proteins, and micronutrients
- Physiologic changes associated with life cycle stage
- Role of oxidative stress and detoxification pathways on health status
- Nutritional biochemical pathways including energy production and detoxification
- Genomics research in practice
- Chemistry of enzymes, co-factors and organic acids
- Lipid metabolism, including cytokine and eicosanoid pathways
- Epigenetics: methyl donor biochemistry and hypo and hyper methylation specific to life cycle stage


Domain III: Nutrients & Human Health (13% of exam)

- Macronutrient and micronutrient food sources and impact on health
- Nutrient deficiency and insufficiency
- causes
- symptoms
- treatment
- Appropriate use of nutrient supplementation
- Supplemental sources of nutrients
- Functional and medical foods and their impact on health
- Role of oxidative stress and detoxification pathways on health status
- Structure and function of soluble and insoluble fiber and impacts on health
- Role of key phytochemicals and zoochemicals in health
- Chemistry of enzymes, co-factors and organic acids
- Impact of agricultural methods and food processing, preparation, and storage on nutrient value
- Tolerable upper intake levels of nutrients
- Nutrient toxicity: causes, symptoms, and treatment
- Dietary Guidelines and Dietary Reference Intakes for preventive and therapeutic interventions
- Nutrients used in fortification and applicable food sources

Domain IV: Nutrition Assessment (13% of exam)

- Lifestyle factors which impact nutrient needs and compliance such as exercise, stress, and sleep
- Comprehensive medical nutrition health history
- Use of behavior change strategies such as Motivational Interviewing and Stages of Change Theory
- Evaluation of laboratory data including identification of optimal value ranges
- Identify signs and symptoms of nutrient status
- Identification of symptoms that require medical referral
- Evaluation of functional testing
- organic acid
- stool
- saliva tests for adrenals and hormones
- Evaluation of hormonal and neurotransmitter imbalances based on laboratory exam
- Computerized analysis of food intake
- Body composition analysis
- skin fold
- bioelectrical impedance
- waist-to-hip
- BMI
- Assessment of single nucleotide polymorphisms (SNPs)
- Nutritional inborn errors of metabolism

Domain V: Clinical Intervention & Monitoring (16% of exam)

- Gauging and optimizing client compliance
- Consideration of clients personal and cultural beliefs when developing nutrition intervention plans
- Malabsorption and effects on macronutrients and micronutrient status
- Effectiveness and contraindications of various diets
- Drug/herb action, duration of action, purpose and dose of a clients current therapeutic regimen
- Interactions between drugs and foods, alcohol, vitamins, minerals, herbs, phytochemicals, and zoochemicals
- Nutrient depletions related to commonly used drugs
- Evidence-based dose and duration of nutraceutical use for common conditions
- Evidence-based use of common botanical supplements for health promotion and common conditions
- Synergistic effects and antagonistic interactions of nutrients in foods and supplements
- Effects of disordered eating patterns on nutrition status, body composition, and body functions
- Safety, toxicity, and interactions of botanical supplements
- Good manufacturing practices and other quality markers for nutritional supplements
- Application of national guidelines, policies, consensus recommendations, and evidence-based research in the development of personalized therapeutic interventions
- Linking childhood behaviors to obesity and other chronic health issues in adults
- Impact of nutritional genomics on health


Domain VI: Medical Nutrition Therapy (MNT) (15% of exam)

- MNT for gastrointestinal disorders
- MNT for food allergies and intolerances
- MNT for autoimmune disorders
- MNT for mental health/mood disorders
- MNT for insulin resistance and type 2 diabetes
- MNT for cardiovascular disease, dyslipidemias, and hypertension
- MNT for endocrine disorders
- MNT for obesity
- MNT for cognitive and neurodegenerative disorders
- MNT for hepatic disorders
- MNT for neurodivergence
- MNT for dermatological disorders
- MNT for bone disorders
- MNT for type 1 diabetes
- MNT for cancer
- MNT for renal disorders
- MNT for hematologic disorders
- MNT for mastication, swallowing, and nutrient absorption disorders
- MNT for pulmonary disorders
- MNT for surgical procedures
- MNT for communicable diseases and sequalae
- MNT for bariatric surgery

Domain VII: Public Health (12% of exam)

- Impact of environmental toxicity on health
- Translation of nutritional epidemiology into practice
- Factors that negatively affect food quality and safety
- Causes and preventative measures for common foodborne illnesses
- Identification of populations at risk for food safety issues
- Tracking current outbreaks of food borne illness and communication with clients

Domain VIII: Practice Management (6% of exam)

- Compliance with ethical standards
- Working within scope of practice and in collaboration with other healthcare professionals as needed
- Evaluate sources of nutrition information for trustworthiness and bias
- HIPAA compliance requirements
- Licensure and certification
- Cultural competency and mitigating implicit bias
- Insurance coverage and reimbursement