I am both a Registered Dietitian (RD) and Licensed Dietitian (LD), so here
are some thoughts from my perspective.  For dieititians, the Registration
exam is national and to qualify to take the exam there are strict education
requirements as well as supervised practice requirements.  In most
states, licensure for dietitians is relatively new, within the past 10 years.

As I remember, licensure was originally pursued for dietitians because
many of the laws and regulations regarding reimbursement for health
care services, specify that the care must be provided by a *licensed*
health professional.  We were advised to seek licensure to ensure that
our services would continue to be reimbursable.  This is has become
even more important with managed care regulations.

Licensure is done on a state by state basis.  Some states do not offer
licensure, some require it, and in some it is optional.  Therefore, the "RD"
is still the most recognized designation for the nutrition professional.  In
states that offer licensure, most hospital and government jobs require
that we be both RD and LD.

In most states, to qualify for licensure,  they basically look at
your RD credentials, and if those are current, then you are eligible to be a
LD.   Because of that, I think that this is just another bureacratic hoop to
jump through, more than a legitimate screening mechanism, and an
expensive one too!

IBCLCs may want to consider that in some areas, if they are not also
licensed RNs (or another licensed health professional), they may not be
eligible for reimbursement for services.

IMHO,
Debi VanderMey Barr
Portland, Oregon
(who pays to be licensed only because it is required for my job)