Holistic Telemedicine for Mental Health

Meet Your Team

Nina Titchenal, NP-C, MSN-Ed

Practice owner & NUrse practitioner

Hi! My name is Nina. I am a Nurse Practitioner, and I believe there is a better way to do patient care. Having been a chronically ill patient myself, I understand the deep struggle that can result from navigating our current healthcare model. Determined to do better for my patients, I started Shepherd Vitality, with YOU in mind. With nine years of nursing experience across many care settings, I understand the value of a provider who truly listens and pursues natural solutions alongside you. I am a Nurse Practitioner licensed to practice in several states and I see patients age 13 and above. Your concerns deserve to be addressed in a way that honors your needs, your story, and your future health. I am here to support you for the long haul.

YOU!

I believe in the transformative potential of patient education, collaboration, and engagement. YOU are the most significant asset to the team when it comes to obtaining the amazing outcomes you've been looking for. I can't wait to work with you and guide you back to Vitality!

Telehealth Services

Complex & Chronic Conditions

Thoughtful Functional Medicine

Without the Fads

Brain Health & Mood: Brain Fog, ADHD, Executive Dysfunction, Anxiety, Depression
Fertility & Postpartum: Men & Women’s Fertility and Preconception Care, Women’s Postpartum Optimization (including for perinatal loss such as miscarriage and stillbirth)
Metabolic & Digestive: Insulin Resistance, Diabetes, PCOS, Metabolic Syndrome, Hypothyroidism, IBS, Chronic Constipation, Reflux/GERD, SIBO, Candida
Complex and Chronic Conditions: Fatigue, Long COVID, Mast-Cell Activation Syndrome, Lyme Disease, Hashimoto’s Thyroiditis, Chronic Pain, Recurrent UTIs/Yeast Infections
Ehlers Danlos / MCAS / POTS Overlap
Visit the FAQ page to get answers to some of the most frequently asked questions.

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Fatigue

Identifying the Root Cause

I help men and women experiencing fatigue to address potentially reversible underlying causes. Many reversible causes of fatigue may be addressed naturally when we take the time to really look.

I understand chronic fatigue can be a debilitating symptom, and thank you for taking the time to reach out for support.

Are you experiencing...

Crushing exhaustion that sleep doesn't fix?
"Brain fog" that makes it hard to remember simple words or tasks?
Feeling completely wiped out even after light activity or exercise?

I provide evidence-based guidance on interventions to support:

Waking up feeling refreshed and ready for the day
Having enough energy to get through a full day of work without a "crash"
Being able to play with your children or grandchildren
Gaining mental clarity and stamina so you can focus on tasks again

Postpartum Support

...In Joy and in Grief...

I help postpartum women to optimize recovery during this crucial season of life. Standard postpartum checkups usually stop six weeks postpartum, often leaving women with symptoms such as

- Debilitating fatigue, emotional overwhelm, gut motility changes, hair loss, weight gain, and difficulty acclimating to a new reality, without clear guidance.

Often, these symptoms aren't just 'part of being a mom'—they are signs that your body’s internal systems are depleted and out of sync. Together we can support your goals of truly enjoying your family and feeling like yourself again.

Note: I support all postpartum women, with a dedicated safe space for those who have experienced perinatal grief and loss, such as miscarriage, stillbirth, early childhood loss, or abortion regret. While most providers offer a quick physical exam and emotional condolences, we will work together to support the rebuilding of your body and regulation of your nervous system as we aim for your best long-term wellbeing.

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Men's Fertility Optimization

I help men to develop targeted strategies to support fertility naturally. Most providers offer a basic sperm count test and suggest IVF. I take a different approach.

If you have been here...

"My doctor said my labs are 'normal,' but we still can't get pregnant."
"I feel like I'm just a bystander in this whole process while my wife does all the work."
"I'm worried my lifestyle or age has already ruined my chances of having a healthy kid."

...I am here to support you in identifying potential causes of fertility struggles and provide clear guidance and next steps. I value your fatherhood and would be honored to be a part of your growing family’s story.

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ADHD & Executive Dysfunction

I help patients struggling with focus using natural solutions and personalized tools suited specifically for your lifestyle, budget, and learning style. You do not need to have previously received a diagnosis elsewhere to schedule an appointment.

If you are struggling with...

Brain fog that makes simple decisions feel impossible
Constant 'mental chatter' that prevents restful sleep and relaxation
Starting five things at once but never finishing any of them

Or if you have already tried....

Stimulant prescriptions that cause unwanted side effects
”Just trying harder”

I am here to Living with a foggy brain and a racing mind makes every day feel like an uphill battle. While most treatments just try to quiet the noise with a pill, they often ignore why your brain is struggling to focus in the first place. Whether it's gut health, nutritional deficiencies, or sleep issues, we will take a deeper look.

Dysautonomia (POTS/MCAS/Ehlers Danlos)

No more medical gaslighting. Let's figure this out together.

Have you been told each of your symptoms is the result of a several separate conditions? Do you have many overlapping chronic conditions? I'm here for you!

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Become a Patient Today!

Book your Discovery Call at calendly.com/shepherdvitality or call (986) 230-5521 to enroll as a new patient. Patients can expect a collaborative and supportive experience. Care may include comprehensive health assessments, targeted lab evaluations, and personalized plans designed to help patients achieve the outcomes they have been seeking.

What patients are saying...

Absolutely top of the line. I cannot recommend Nina Titchenal, Functional Health Nurse Practitioner, highly enough. If you are struggling with fatigue, fertility challenges, ADHD, executive dysfunction, or preparing for conception (for yourself or your partner), this is the provider you’ve been looking for. As an added bonus, she does telehealth, so there is NEVER a 45 minute long wait in a doctor's office. From the very first step, I knew her approach was different. She sends out the most comprehensive medical questionnaire I have ever completed, it covers everything from childhood health to current daily habits, stress levels, environment, and more. It’s clear she leaves no stone unturned. But here’s where she truly shines: our first visit. She spent over an hour with me - actually listening, asking thoughtful follow-up questions, and connecting dots that no other practitioner ever had. She didn’t rush. She didn’t dismiss my symptoms. Instead, she gave me a clear, actionable roadmap to rebuild my health from the ground up. Whether you’re dealing with brain fog and exhaustion, trying to conceive, or navigating pre- and post-conception health for you and your partner, she meets you where you are with expertise and genuine compassion. Her understanding of ADD/ADHD and executive dysfunction is particularly exceptional. She looks at the root causes, not just the symptoms. If you want someone who will treat you like a whole person, not a chart number, and partner with you to create your best health for the future, book with her.

Michelle, 58

What sets Shepherd Vitality apart?

Many patients today feel rushed through appointments—unheard, dismissed, and handed another prescription without clear answers or care that truly aligns with their needs. Shepherd Vitality was created for patients who are ready to be listened to, understood, and guided with intention. I prioritize time and depth. Initial visits are 60–90 minutes, with follow-ups ranging from 15–45 minutes—allowing space for meaningful conversation and thoughtful care, not rushed interactions. And my work doesn't stop when your visit ends. Behind the scenes, I'm researching, refining, and building a plan tailored specifically to you, so each step forward is intentional and informed. I also recognize that your health is best supported by a team. While we focus on root-cause, whole-person care, we actively collaborate, refer when appropriate, and communicate with your other providers when necessary to ensure your care is coordinated—not fragmented. My goal is to guide you back to Vitality with clarity, support, and a truly personalized approach.

What is functional medicine and how does it differ from the traditional medical model of care?

Functional Medicine is a personalized, holistic approach to healthcare that focuses on identifying and treating the root cause of disease rather than only focusing on symptom management. This approach focuses on treating the whole person with the goal of restoring FUNCTION, VITALITY, and QUALITY OF LIFE. Rather than viewing each body system as a separate entity, this approach views your body as a network of systems, tracing systems through interconnected pathways to find the drivers of disease. Functional medicine focuses on identifying and addressing the root causes of health issues rather than just treating symptoms. Unlike traditional medicine, which often focuses on disease diagnosis and medication management, functional medicine takes a holistic approach by considering factors like lifestyle, environment, and nutrition to optimize overall health. This method encourages thorough assessments and personalized treatment plans, aiming for long-term wellness rather than temporary fixes. Health is not a static state. It is an ongoing balancing act between our body's internal physiology and our external environmental factors (nutrition, toxin burden, stress, sleep, community, movement, and other factors). Unlike traditional medicine, which often follows a 'one-size-fits-all' model, functional medicine considers each patient's unique history, genetics, and lifestyle factors to create personalized treatment plans that get down to the root of the problem. This is truly patient-centered care.

What are the benefits of telehealth (telemedicine)?

Telehealth allows you to receive high-quality, personalized care from the comfort of your own home—without the time, stress, and inconvenience of travel or waiting rooms. It makes care more accessible and flexible, so you can stay consistent with your visits, ask questions when they arise, and integrate your care plan into your real daily life. It also reduces your exposure to other sick patients, helping you stay well while seeking care.

What is your approach to care?

I am focused on the WHY of your symptoms. Rather than simply managing your symptoms, I will collaborate with you to explore why your symptoms started and how to address them with evidence-based natural solutions that are tailored to your lifestyle, priorities, and preferences. I will guide you to the root cause of the problem and provide clear recommendations on how we can address it in a way that is realistic for your unique situation. Step 1 — Comprehensive Intake Detailed symptom history, lifestyle review, labs, timeline mapping. Step 2 — Root Cause Assessment Evaluation of nutrition, sleep, hormones, inflammation, metabolic patterns, stress physiology, environmental toxin burden, etc. Step 3 — Personalized Plan Targeted nutrition, lifestyle, supplements, further testing if indicated, and medication optimization when appropriate. Step 4 — Ongoing Partnership Follow-up care, progress tracking, refinement over time.

How do I schedule an appointment?

Scheduling an appointment is simple: Visit https://calendly.com/shepherdvitality to book your Discovery Call and I will call you at the number you have specified. *The scheduling link above is for contact purposes only, do not submit personal health information in your form* OR Call (986) 230-5521 to request to enroll as a new patient. You will be sent an invitation to the patient portal. Create a new account in the PracticeBetter portal and log in to complete new patient intake forms. After this, you can select an appointment time within the patient portal.

What will my first telehealth appointment be like?

During your first telehealth appointment with Shepherd Vitality, you can expect a warm and supportive environment. I'll take the time (usually 60 - 90 minutes) to thoroughly discuss your health history, current concerns, and lifestyle factors that may impact your well-being. We will discuss the season of life you are in and which aspects of health progress are most important to you. You will receive education on your specific health patterns and any pertinent recommendations for lifestyle interventions, nutritional integrations, lab work, and supplements, or medications. You are in the driver's seat. This information is offered to you, and recommendations are made to help you make an informed decision about your health This is a collaborative process where we'll focus on understanding your unique needs and goals. After our discussion, we'll develop a personalized plan tailored to your holistic health objectives in a way that is realistic for your lifestyle, health budget, and schedule.

How do you care for women walking through perinatal loss, such as miscarriage, stillbirth, early child loss or abortion regret?

As I was processing an already-difficult birthing process into motherhood, my husband and I experienced the loss of our full-term stillborn son in 2024, while parenting our two other young children. That experience refined my vision for the care of patients experiencing true hardship, struggle, and loss. I strongly believe that your concerns deserve to be addressed in a way that honors your motherhood, your child, your family’s story, and your future. I am here to support you. If you are a woman who is recovering from miscarriage, stillbirth, or another form of perinatal grief and loss, I am here to support you as a whole person - physically, mentally, spiritually, and emotionally.

Do you accept insurance?

Due to the administrative barriers inherent to medical insurance, Shepherd Vitality is a cash-pay practice. Choosing a cash-pay model allows me to provide care directly to you, without the middleman - free from corporate constraints and unnecessary red tape. Using the cash-pay model allows for FULL pricing transparency and control over which services you actually want to pay for. While cash-pay care can feel more expensive upfront—especially if you're already paying into insurance—it often ends up being more cost-effective than being passed between multiple specialists who focus on isolated symptoms or body systems without comprehensively addressing how they interact with one another. My approach is to look at the whole picture, address root causes, and treat your body as an interconnected system rather than a collection of separate issues.

Looking for answers? Experiencing information overload?

Many patients who have pursued functional medicine consultations know the feeling. You came to your visit looking for practical answers and straightforward next steps. You left with 10 new supplement recommendations and a patient education summary that sounded more like a biochemistry article than an actionable plan. The frustration is real.

I am committed to providing you with CLEAR, ACTIONABLE, PRACTICAL patient education tailored to your lifestyle and budget. You’ll walk away from your telehealth visit with a plan that focuses on what matters to you, not just your diagnosis or numbers.

Some patients want a simple place to start; others are ready for a 15-step plan. Whether you’re looking ttwo practical next steps or fifteen, I tailor your care to your capacity to make changes, at your pace.

Learn more

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Platforms Used

Calendly Patient Scheduling

Initial call scheduling for Q&A and new patient enrollment is completed via the Calendly link and can be accessed by clicking HERE.

EHR & Patient Portal

Shepherd Vitality utilizes the PracticeBetter EHR and patient portal for easy patient access to records and messaging. If you are an enrolled patient and have created an account, you may access your patient portal by clicking HERE.

Paubox HIPAA-Compliant Secure Email

Our info@shepherdvitality.com email is secured by Paubox. To learn more about this HIPAA-compliant emailing platform, you can click HERE.