You take care of everyone.
Who takes care of you?
Nishi Jani Rajguru
CNP, APRN, PMHNP-BC, ADHD-CCSP
I am a board certified Psychiatric Nurse Practitioner and Certified ADHD Clinical Provider, helping women and healthcare professionals across Ohio manage ADHD, anxiety, depression, insomnia, and burnout.
Experienced integrative psychiatry clinician, leader, educator, mentor, consultant, public speaker, writer, and mother.
Telehealth across the state of Ohio.
Appointments available around your schedule:
Morning, Evenings, & Weekends
Get started by scheduling a free 15 minute call with me.
Are you surviving right now?
Can you remember the last time you felt like you were thriving?
Why Psych Clarity?
One clinician, always.
The same person every visit — someone who knows your history and how you want to be treated.
Ninety-minute first visits.
Long enough to understand what's actually going on and decide what to start working on first.
Appointments that fit around you.
Early mornings and evenings, for first visits and follow-ups both. As well as some weekend options for the initial visit. Built for people who have a hard time taking a day off.
ADHD that got missed.
The diagnostic criteria was written around boys, and a lot of women spent years compensating well enough that nobody looked. I'm certified in ADHD care. I evaluate carefully rather than quickly, and treatment covers more than a prescription: stimulants, non-stimulants, skills, and targeted supplements.
Deprescribing, not just prescribing.
As willing to take you off something as put you on it.
More than a medication check.
Longer visits leave room for skills, context, and the parts that don't fit in brief med check visits. If you already have a therapist, I work alongside them, not instead of them.
Labs, sleep, diet, and lifestyle.
Not an afterthought. Part of understanding everything that's contributing.
Discreet by design.
No insurance claim, no shared chart, no waiting room.
Service you can’t sustain isn’t service.
It is depletion with a better name.
My name is Nishi Jani Rajguru
I am a psychiatric nurse practitioner with more than 13 years of experience across a range of psychiatric settings.
I am passionate about helping you better understand and manage your brain.
I strive to empower people with tools and knowledge that allow them to take control of their mental health.
How I Got Here:
I was the first nursing student accepted into a psychiatric co-op at Cincinnati Children's, after asking for a placement that didn't exist yet.
The program stayed open after I left, and other students have gone through it since.
Psychiatry felt aligned with my values and called to me since my first psychiatric rotation.
I feel blessed that I get to listen to your story and support you.
Training and Experience:
- BSN, University of Cincinnati
- MSN, University of Akron
- Board certified psychiatric mental health nurse practitioner (PMHNP-BC)
- Certified ADHD clinical services provider (ADHD-CCSP)
- Certified Epic physician builder
- 6 years at Cincinnati Children's Hospital in adolescent psychiatry, inpatient and partial hospitalization
- 2 years in private practice and consulting for nursing homes and assisted living facilities
- 5 years in outpatient psychiatry at Cleveland Clinic, serving as preceptor coordinator and mentoring Psych NP students and new graduates.
- Speaker at psychopharmacology conferences and at programs for nurse practitioners transitioning into practice
My Purpose:
I built Psych Clarity because I wanted the time to look at the whole person.
Opening up about your mental health is hard for anyone.
It's harder for women and healthcare professionals who are used to being the ones holding everything together.
I wanted to give people a chance to fully tell me their story and where they are struggling the most right now.
Then I ask the harder questions.
Does this diagnosis still fit? Is this medication still helping, or is it just familiar? Is the exhaustion from depression, thyroid, low iron, or 8 years of 5-hour nights?
I screen for ADHD at every intake because it often sits underneath the anxiety and the exhaustion and unfortunately gets overlooked often.
Are you surviving right now - and can you remember the last time you felt like you were thriving?
This takes time, and it's what I build the practice around. First visits are 90 minutes. Follow-ups are 30 or 60 minutes, and we choose that together.
If you already have a therapist and want your medication managed well, 30 minutes are often plenty. If the hour is what you need, we get you scheduled an hour.
When it helps, I'll coordinate with your other providers with your permission and your input. I can advocate on your behalf, and I can help you prepare for the conversations you need to have with them or with your family.
Where I Stand on Medication:
I prescribe, and I'm good at it. Psychopharmacology is what I teach other clinicians.
I also deprescribe, which is a real gap in psychiatric education and care.
I don't come in with a default. Some visits end with a higher dose, some with a different medication, and some with a plan to taper off something you no longer need. What I recommend depends on what's actually happening with you.
If You Work in Healthcare:
You're good at staying calm when things go sideways, reading what other people need before they ask, and functioning on very little sleep.
Those skills work, and they also make it easy to keep going well past the point where you would have told a patient to stop. I've been on that side of it more than once.
Personal Life and Values:
Like many of you, I'm juggling more than one role. I live in Northeast Ohio with my husband and our young daughter in a multigenerational household where we help care for our parents and grandparents.
I spend as much time outdoors as I can, whether that's hiking, doing yoga, or meditating by a waterfall.
Spirituality and service are a big part of my value system. I've volunteered at my Hindu temple since I was a teenager, and lately I've been working to reduce stigma and build mental health awareness in the South Asian community.
Conditions I Specialize in Treating
You don’t get peace by removing the pressure.
You find it underneath.
The 90 minute initial visit
Diagnostic Clarity
A full history rather than a symptom checklist.
How is your nervous system responding? Some people run wired and reactive, while others go flat and numb. Both get labeled anxious or depressed.
whether the diagnosis you were given still fits, and whether anything has been missed.
Sleep and Circadian Rhythm Review
Poor sleep can look like depression, anxiety, ADHD, or burnout, sometimes all at once. It's rarely the first thing anyone asks about.
If sleep dysfunction is a key symptom, CBT-I is where we start, as it's the gold standard treatment, and it's not a sedative sleeping medication.
I can prescribe SleepioRX, an FDA-cleared digital CBT-I program you work through at home. Their team handles the insurance side to support you with treatment coverage.
ADHD and Executive Function
I screen for ADHD at every intake.
It isn't only difficulty focusing.
It's neurological dysregulation that affects mood, motivation, impulsivity, how you manage time, effort, energy, and sleep.
In women, it often gets attributed to anxiety or hormonal changes for years before anyone evaluates it directly.
Labs and Physical Contributors
Thyroid
Iron and ferritin
B12
Vitamin D
Magnesium
Inflammatory markers
A metabolic panel.
Screening for nutrient deficiencies and ruling out physical causes before symptoms get attributed to anxiety or stress.
Medication Review
What you're actually taking, why it was started, and whether it's still helping.
Whether the dose is right and if you still need to continue taking it.
Explore a Day in Your Life
How do you eat, how do you move, what do you drink, and whether any part of the day belongs to you?
Who depends on you, and also the parts you'd never bring up at your own appointment.
Our Services
Out of Network
Superbill provided upon request
Insurance may reimburse up to 80%
Call & check your out of network behavioral health benefits.
Healthcare Provider Discount
Concierge Membership
-
Your first visit. We use the full 90 minutes to understand your history, your current symptoms, what you've already tried, and what's going on physically alongside what's going on emotionally. You leave with a working formulation and an initial plan, including any lab work worth ordering.
-
Medication management plus the work that usually gets cut for time; integrative and lifestyle guidance, executive function strategies, and any parenting or communication support needed. Flat rate, regardless of what we decide to focus in that hour.
-
For patients who are stable, or who are already working with the therapist and need focused medication management with brief integrative and lifestyle guidance.
-
Includes:
Starts after comprehensive evaluation.
One 60-minute and one 30-minute visit each month
Same-day response during business hours
Direct text access
Paperwork and forms at no charge in between the appointments
Priority scheduling
20% off any additional visits ($280 for 60 minutes, $160 for 30 minutes).
Membership is capped, and $650 is the founding rate. If you join in the practice’s first twelve months, that’s your rate for as long as you stay a member. Membership opens at $750 after the first year based on availability.
-
Clinicians who join in the practice's first twelve months receive 20% off all services, locked in for as long as they remain a patient.
That's $400 for a comprehensive evaluation, $280 for a 60-minute follow-up, and $160 for a 30-minute follow-up.
Clinicians who join after the first year receive 10% off.
Eligibility is confirmed with a quick license lookup during your free call.
-
You pay at the time of service.
Under the No Surprises Act, you have the right to a written estimate of what your care will cost.
What “Integrative” actually means here.
-
There is real evidence that dietary pattern affects depression, and that regular exercise works on par with medication for mild to moderate symptoms.
I'll ask what you're eating and how much you're moving, because both are part of the clinical picture.
-
Running on high alert for long stretches affects sleep, appetite, immune function, and how quickly you recover from anything.
Resilience drops along with it.
-
The right one, at the lowest dose that works, with a plan for what happens if it works and what happens if it doesn't. Including stopping.
Coming off a psychiatric medication safely takes more skill than starting one. Not every medication is meant to be permanent, and safe tapering is part of what I do.
-
The word gets used loosely, so here's what it means in this practice.
It doesn't mean anti-medication. I prescribe, and I'm good at it. It doesn't mean a supplement protocol standing in for treatment. It isn't functional medicine, I won't order tests that can't be meaningfully interpreted, and I won't build your treatment plan around products.
What it means is that I look at what's happening in your body, too. Physical problems often show up first as anxiety, low mood, or trouble concentrating.
-
Low iron looks like exhaustion and poor concentration. Thyroid dysfunction looks like depression, or anxiety, or both.
Low B12, low vitamin D, blood sugar swings, and chronic inflammation all produce psychiatric symptoms, and all of them show up on labs.
-
When sleep improves, a lot of other things improve with it.
Cognitive behavior therapy for insomnia, or CBT-I, works more consistently than a sleeping pill and keeps working after treatment ends.
CBT-I also avoids the side effects that sleep medications carry, prescription and over-the-counter alike, in both the short and long term.
Your Questions, Answered
-
Fill out the request for a free 15-minute call with Nishi to see if this practice is the right fit for you. After the call, you will be assisted in scheduling your first appointment.
-
Yes, I offer secure virtual sessions so I can provide care to patients from the comfort of their own space. I know how challenging it can be to schedule a visit, and I want to make care as accessible and convenient as possible.
-
Life happens, and I understand that. If you need to cancel or reschedule, please notify me at least 24 hours in advance to avoid being charged for the visit.
-
No. Most of my patients are women in a range of careers and life stages.
I also see healthcare professionals.
Being a clinician is a focus because I understand the specific problem: you can't take a day off to get care, and you have real questions about what a psychiatric record means for your license.
But you don't need a badge to be a patient here.
-
No. Psych Clarity is out of network with every insurance plan. That's a deliberate choice, and it puts you in control of both the time and the treatment.
Insurance is what produces fifteen and twenty-minute appointments, and diagnoses assigned to satisfy a billing requirement rather than to describe you.
If you'd like to seek out-of-network reimbursement, I'll provide a superbill on request.
Call your plan before your first visit and ask what they cover.
-
An itemized receipt with the codes your insurer needs.
You submit it; they reimburse you directly if you have out-of-network benefits.
-
Yes. Most plans cover psychiatric care. Confirm with your plan administrator.
-
Yes, I am licensed to prescribe medications when appropriate. (Being seen for an appointment does not guarantee that medication will be prescribed that day.)
Medication decisions are made collaboratively, and refills can be requested through the patient portal with sufficient notice to avoid interruptions
-
Prescribers can provide controlled medications in accordance with DEA regulations and any applicable extensions to telehealth prescribing laws. The ability to prescribe controlled substances via telehealth may be subject to regulatory changes and is currently authorized under temporary extensions.
-
Longer visits include brief supportive therapy life style strategies and skills work alongside medication.
If you're already seeing a therapist, I'm glad to work in a medication-management role and coordinate with them.
-
Yes, the psychiatric side of it. If your OB-GYN or primary care clinician has established that you're perimenopausal, I'll work alongside them on the mood, sleep, and cognitive symptoms rather than duplicating their hormonal workup. I do not prescribe HRT.
-
Typically within one business day.
-
Ohio. You need to be physically located in Ohio during your appointment.
Does this feel familiar?
You're the one people rely on. You know where everything is, who needs what, which deadline is real and which one isn't. You answer the message at 11 at night and tell yourself you'll go to bed right after.
Somewhere it stopped feeling like competence and started feeling like a burden. You're short with people you love, and then you lie awake replaying it. You've been called put together so many times that it's become a thing you have to keep up.
Maybe you've read about anxiety and ADHD and closed the tab. Maybe nothing is technically wrong, and that's the part you can't explain to anyone.
You're not failing. You've been carrying something without support, and you've been good enough at it that nobody noticed, including you.
There's a version of this you don't say out loud.
You've already diagnosed yourself. You know exactly what you'd say to a patient in your position. You probably said it to someone this week.
You can get anyone an appointment except you. You tell patients and your own family that sleep matters while you're running on 5 hours.
You've watched what happens when a colleague takes leave, so you've done the calculation and worry about what this may cost your career. You wondered whether your struggles are even bad enough to count because you've seen people go through worse.
You've been weighing it for a while now. Whether it's even worth talking about, you worry about your credibility. Some days you call it an occupational hazard and let yourself off the hook.
Those are fair questions but you also know that running like this has a limit.
Schedule your 15 minute free call with Nishi
Have a Question?
Send us a quick note and we’ll reach out within one business day—no pressure, just answers.