Medication Management Psychiatrist in North Carolina

I’m Dr. Shantanu Baghel, a board-certified psychiatrist practicing across North Carolina, in person and by video. I take a small number of patients at one flat fee of $250 a month, and I’m accepting new ones now.

Psychiatric Care in North Carolina

I run a single-physician practice. You’re evaluated by me, your plan is built by me, and I’m the one you see at follow-up.

Access to psychiatry in this state is scarce. As of June 30, 2026, HRSA reports that North Carolina’s designated mental health shortage areas have 11.96% of their need for providers met, against 26.53% across all such areas nationally. There are 229 designated areas covering more than 4.5 million residents, and the UNC Sheps Center counted 1,245 physicians working as psychiatrists here in 2024.

That scarcity is why this practice runs a small panel with long appointments and direct access to me.

What I Treat

I treat depression, including treatment-resistant depression, along with anxiety disorders and panic, bipolar disorder, adult ADHD, PTSD and trauma-related conditions, OCD, insomnia and circadian problems, and premenstrual dysphoric disorder.

I also manage the places where psychiatry meets endocrine and metabolic medicine, such as testosterone and mood, GLP-1 medications and mental health, thyroid function, and the metabolic side effects of psychiatric medication. That overlap is a large part of what this practice is built around.

I see adults. I don’t treat children or adolescents.

How Care Works Here

Your first appointment is a comprehensive psychiatric evaluation, 45 to 60 minutes. I take a full psychiatric and medical history, review every medication you’ve tried and what happened on it, look at relevant labs, and build a plan with you.

After that, we meet as often as your care needs. Between appointments you can message me directly. A question about a side effect or a dose gets answered the same day in most cases.

If I order labs, I go through them with you and explain what they change about the plan.

Medication Management

Most of what I do is medication management. Here is what that involves.

It means knowing why you’re on what you’re on. It means titrating deliberately, with a target and a timeline, and knowing when a trial has been adequate. It means monitoring the things that need monitoring: metabolic panels on antipsychotics, lithium levels and renal function, hematocrit on testosterone, QTc where it matters.

It also means being willing to stop a medication that isn’t earning its place. Polypharmacy accumulates quietly, one addition at a time. Part of the job is reviewing the whole list on a schedule.

I prescribe the full range, including controlled medications where they’re clinically indicated and appropriate monitoring is in place.

Telepsychiatry and In-Person Care Across North Carolina

This is a hybrid practice. I see patients in person and by video, and most people use both at different points.

Video works well for ongoing medication management, for people who live far from Wilmington, and for anyone whose schedule makes a drive impractical. In-person visits are at the Wilmington office, 2460 Delaney Ave, and are sometimes the right call, particularly early on or when something needs a closer look.

By video you get the same physician, the same appointment length, and the same clinical standard as sitting in the room. You need to be physically located in North Carolina at the time of your appointment.

Tapering and Deprescribing

Coming off a psychiatric medication is a substantial part of my practice, and it’s included in the same fee.

I use hyperbolic tapering, where each reduction is a percentage of your current dose. It can take months. It sometimes takes longer than that, and I’ll say so at the start.

My antidepressant tapering and deprescribing page explains a supervised taper step by step, along with the medications I taper and what it costs.

I’ve written in more detail about tapering off fluoxetine and paroxetine, about venlafaxine withdrawal, and about antidepressant discontinuation syndrome.

What It Costs

One flat fee of $250 a month. That covers your evaluation, every visit after it, and messaging between visits.

Labs and medications are billed separately. The lab bills you at their rates, your pharmacy bills you for prescriptions, and that includes testosterone and GLP-1 medications, which carry their own costs. Forensic psychiatric work isn’t part of the practice membership and is billed separately at $400 an hour.

There’s one price and no tiers. $250 a month, month to month, with no contract and no minimum term.

For reference on the surrounding claims data: in 2024, clinicians in North Carolina who billed an initial psychiatric diagnostic evaluation in an office setting submitted an average charge of $377.76. That’s the list charge on the claim, not a negotiated rate and not a cash price.

Federal law gives you the right to a written estimate of what your care will cost before you receive it, under the No Surprises Act. It applies here specifically because I don’t bill insurance. The regulation covers anyone who’s uninsured, and it also covers anyone who has coverage but chooses not to file a claim. You can request a Good Faith Estimate at any point, including before you book.

Accepting New Patients

I’m taking new patients now.

The panel is deliberately small, which is what makes the appointment length and the direct messaging possible. When it’s full, I’ll say so on this page and give you a realistic date. Book a free 15-minute consultation.

Starting Care

Start with the free 15-minute consultation. We’ll cover what’s going on, whether I’m the right physician for it, and when I could see you. If I’m not the right fit, I’ll say so on that call and point you somewhere better.

Frequently Asked Questions

Do you take insurance?

No. I don’t bill insurance and I’m not in any network. Working outside insurance is what lets me keep a small panel and hold the appointment length.

How much does a psychiatrist cost here?

$250 a month, flat. The annual number is the easiest one to hold onto, $3,000 for a year of care. Labs and medications are billed separately.

Are you accepting new patients?

Yes, as of August 2026. Start with the free 15-minute consultation and we’ll talk about timing.

Do I have to come to the office?

Not necessarily. I see patients in person and by video across North Carolina. You need to be physically located in the state at the time of your appointment.

Can you help me come off a medication I’m already on?

Yes, and it’s included in the monthly fee. Tapering is a large part of my practice. Bring your current doses and how long you’ve been on them to the consultation.

Do you prescribe controlled medications?

Yes, where they’re clinically indicated and appropriate monitoring is in place. That includes stimulants for adult ADHD. Every prescription follows a comprehensive evaluation and regular follow-up.

This page is for general information and isn’t medical advice or a treatment recommendation for any individual. Reading it doesn’t create a physician-patient relationship. If you’re in crisis, call or text 988 to reach the Suicide and Crisis Lifeline, or call 911.

References

1. HRSA Bureau of Health Workforce. Designated HPSA Quarterly Summary, FY2026 Q3, as of June 30, 2026.
2. Lombardi BM, Headley J, Jimenez MP, et al. NC MH&SU Services Workforce Data 2024 Snapshot. Sheps Center, UNC-Chapel Hill. Published May 6, 2026.
3. 45 CFR 149.610. eCFR, Title 45, current as of July 30, 2026.
4. Horowitz MA, Taylor D. Tapering of SSRI treatment to mitigate withdrawal symptoms. Lancet Psychiatry. 2019;6(6):538-546. PMID 30850328.
5. CMS. Medicare Physician & Other Practitioners, by Geography and Service, CY2024. North Carolina, HCPCS 90792, place of service O.