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.
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 mothers 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 based on what the visit actually needs.
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.
Your Questions, Answered
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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.
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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.
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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.
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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.
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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.
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An itemized receipt with the codes your insurer needs.
You submit it; they reimburse you directly if you have out-of-network benefits.
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Yes. Most plans cover psychiatric care. Confirm with your plan administrator.
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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
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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.
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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.
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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.
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Typically within one business day.
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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.