Medication Management Psychiatrist in North Carolina

I’m Dr. Shantanu Baghel, a board-certified psychiatrist in Wilmington, North Carolina. I take a small number of patients at one flat fee of $350 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.

My page on anxiety treatment in North Carolina explains how I evaluate and treat panic and the other anxiety disorders.

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, about 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, you book follow-ups as your care needs them, up to two visits a month in all. Between appointments you can message me directly. I answer messages within 1 to 2 business days.

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. Part of the job is reviewing the whole medication list on a schedule.

Every medication decision, controlled medications included, is individual and follows a full evaluation.

Telepsychiatry Across North Carolina, In-Person Care in Wilmington

I see patients by video anywhere in North Carolina, and in person at my Wilmington office by request.

Video works well for ongoing medication management, for people who live far from Wilmington, and for anyone whose schedule makes a drive impractical. The office is at 2460 Delaney Ave.

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 $350 a month. That covers up to two visits a month, including your evaluation, and messaging between appointments.

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. $350 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. Book a free 15-minute consultation.

Starting Care

Start with the free 15-minute consultation. I reply to messages within 1 to 2 business days, and after the call I book your evaluation on my next open date.

Frequently Asked Questions

Do you take insurance?

No. I don’t bill insurance for my monthly practice, 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?

A flat $350 a month covers up to two visits. Labs and medications are billed separately.

Are you accepting new patients?

Yes. Start with the free 15-minute consultation. After the call, I book your evaluation on my next open date.

Do I have to come to the office?

No. I see patients by video anywhere in North Carolina, and in person at my Wilmington office by request. 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?

It’s an individualized decision. When a controlled medication is clinically indicated, the prescription follows a comprehensive evaluation, with appropriate monitoring 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 (5)

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.