- The exam has 150 questions: 125 scored plus 25 unscored pretest items, with three hours of testing time.
- Nutrition Assessment carries 55 scored items, Nutrition Interventions 47, and Foodservice and Food Safety 23.
- The fee is USD $350, paid when you schedule; retesting normally requires reauthorization and a 60-day wait.
- Eligibility needs two years as a Registered Dietitian plus 2,000 verified gerontological-nutrition practice hours.
The One-Page Snapshot
The Certified Specialist in Gerontological Nutrition credential is awarded by the Commission on Dietetic Registration (CDR), the credentialing arm for registered dietitians. CDR also describes it as Board Certified Specialist in Gerontological Nutrition, and you will see both names in official materials. This cheat sheet condenses the facts you need to keep straight in the final weeks before testing. If you are still deciding whether to pursue the credential, start with What Is CSG Certification? and come back here when you are ready to consolidate.
| Item | What to Know |
|---|---|
| Credentialing body | Commission on Dietetic Registration (CDR) |
| Format | 150 multiple-choice questions, one best answer from four options |
| Scored vs. unscored | 125 scored, 25 unscored pretest questions |
| Testing time | Three hours, plus a separate 20-minute tutorial (three hours 20 minutes total appointment) |
| Fee | USD $350, paid at scheduling |
| Delivery | Computer-based at Pearson VUE test centers, year-round |
| Reference materials | Closed-book; on-screen calculator provided |
| Retest policy | Reauthorization and a 60-day wait, normally |
| Validity | Five years |
Who Can Sit for It
CSG is a specialty credential layered on top of the RD credential, so eligibility is practice-based rather than coursework-based. The two core requirements are:
- Current CDR Registered Dietitian status held for at least two years by the examination date.
- 2,000 verified hours of gerontological-nutrition specialty practice as an RD during the five years preceding your application.
Approved education or professional substitutions can cover up to 800 of those hours. The wording of what counts as qualifying specialty practice and which substitutions are accepted is set by CDR, so confirm details against the official application before you assume your hours qualify. Our CSG requirements guide walks through documentation and common gaps, and the certification cost breakdown covers the budget side.
The Three Domains and Their Item Counts
The CDR Examination Content Outline for CSG (copyright 2024) defines three domains. Note carefully how the outline presents weighting: it allocates scored item counts, not published percentage weights. Resist the temptation to convert them into percentages and quote them as official figures.
| Domain | Scored Items | Relative Emphasis |
|---|---|---|
| Domain 1: Nutrition Assessment | 55 | Largest allocation |
| Domain 2: Nutrition Interventions | 47 | Second largest |
| Domain 3: Foodservice and Food Safety | 23 | Smallest, but not optional |
Together these account for the 125 scored questions. For a deeper breakdown of what each domain covers, see the complete guide to all three CSG content areas.
Domain 1: Nutrition Assessment (55 scored items)
The biggest block, and the one that rewards clinical depth with older adults. Expect scenario questions that ask you to interpret data and decide what it means.
- Screening versus full assessment: knowing which tool or step fits which situation
- Weight history, unintended weight loss, and body composition changes in aging
- Biochemical and clinical indicators, and how medications and chronic disease complicate their interpretation
- Swallowing, chewing, dentition, and functional status as drivers of intake
- Estimating energy, protein, and fluid needs in older adults
Domain 2: Nutrition Interventions (47 scored items)
Once you have assessed, what do you do? Questions here tend to ask for the best next action given a specific resident, patient, or community-dwelling client.
- Diet order modifications, texture and liquid considerations, and therapeutic diets for common geriatric conditions
- Oral nutrition supplements, fortification, and enteral or parenteral decisions at a conceptual level
- Managing poor appetite, dementia-related feeding challenges, and polypharmacy effects on nutrition
- Counseling, education, and care-team coordination
- Monitoring and evaluating whether the intervention is working
Domain 3: Foodservice and Food Safety (23 scored items)
The smallest domain, but candidates who live purely in clinical practice often underprepare for it, which makes it a place where points leak.
- Menu planning and meeting the needs of older adult populations at an institutional level
- Food safety principles and risks that matter for vulnerable older adults
- Sanitation, storage, and handling practices in long-term care and community meal settings
- Operational and regulatory awareness in facilities that serve older adults
Exam-Day Mechanics
Format and Pacing
Every question is multiple choice with one best answer among four. "Best" matters: more than one option may be defensible, and you are choosing the most appropriate given the scenario. With 150 questions in three hours, you have roughly 72 seconds per question on average, so a pace check at the halfway point is worth building into your plan.
Rules That Catch Candidates Off Guard
- No going back: You must answer the current question before advancing. Make a decision, even a provisional one, and move on.
- The clock keeps running: Ordinary unscheduled breaks do not stop the timer.
- Closed-book: No reference materials. An on-screen calculator is provided; personal calculators are prohibited.
- Tutorial time is separate: The 20-minute tutorial is not deducted from your three hours of testing.
Scheduling, authorization steps, and timing are covered in our CSG exam dates and scheduling guide. Because testing is available year-round at Pearson VUE centers, your constraint is usually authorization and your own readiness rather than a narrow testing window.
Reported Results and How to Read Them
CDR publishes pass/fail statistics for the credential. For January through June 2026, it reports:
- Overall passing: 90%, which is 64 of 71 examinees.
- First-time passing: 87%, which is 41 of 47 examinees.
- Recertification row: listed as 96% alongside a count of 21 of 22.
That last row contains an internal discrepancy: 21 of 22 does not equal 96%. We are reporting it exactly as CDR presents it rather than quietly correcting it, and we would not treat it as a reconciled figure. If the recertification number matters to your decision, check the source table directly.
What "Passing" Actually Means
Passing is set through Angoff standard setting and statistical equating to account for differences in form difficulty. There is no fixed percentage of candidates who pass, and no raw passing percentage is published. Do not chase a rumored cut score; aim for consistent command of all three domains. Our passing score explainer covers this in more detail.
High-Yield Topics to Memorize
The exam is a specialist test, so it assumes RD-level foundations and probes how well you apply them to older adults. Organize your last-pass review around the question types each domain tends to generate.
Assessment Patterns
- Distinguish unintentional weight loss from expected change, and know why it is clinically meaningful in older adults.
- Recognize how dehydration, medications, and acute illness can distort lab values and clinical impressions.
- Connect functional and oral-health problems (dentition, dysphagia, impaired self-feeding) to intake and risk.
- Know what to gather in a nutrition-focused history for a person who cannot self-report reliably.
Intervention Patterns
- Match the intervention to the cause: a supplement does not fix an environmental or assistance problem at mealtimes.
- Weigh therapeutic diet restrictions against the risk of undernutrition; liberalization is a recurring theme in geriatric nutrition care.
- Understand when a swallowing concern should trigger referral and coordination with other disciplines.
- Know what to monitor, and when, to judge whether an intervention succeeded.
Foodservice Patterns
- Identify foodborne-illness risks that are heightened in older adults and the controls that address them.
- Apply menu-planning logic to a population with varied texture, diet, and cultural needs.
- Recognize safe handling, temperature, and storage principles in a facility setting.
Key Takeaway
Most questions are applied, not recall. When reviewing a topic, practice stating what you would do and why for a specific older adult, rather than just reciting definitions. The "why" is what separates the best answer from a merely plausible one.
Sequencing Your Review Around the Domains
If you are building a compressed review plan, let the item counts drive the order. Assessment is the largest block, so it gets the first and heaviest pass; foodservice is the smallest, but it is also the domain clinicians most often neglect, so it needs a dedicated slot rather than a leftover one. A fuller approach is laid out in the CSG study guide.
Nutrition Assessment, first pass
- Screening versus assessment, weight and body composition, indicators in aging
- Work scenario questions and note every miss by cause
Nutrition Interventions
- Diet modification, supplementation, feeding difficulties, monitoring and evaluation
- Practice choosing the best next action among close options
Foodservice and Food Safety, plus Assessment review
- Dedicated foodservice block, then revisit weak Assessment areas
- Take a timed mixed set at roughly 72 seconds per question
Integration and pacing
- Full-length timed practice, no pausing, no reference materials
- Review every miss and rebuild the weakest domain
Adjust the length to your own background. A dietitian who works daily in long-term care will need less time on Assessment and Interventions and more on foodservice rules; someone coming from a different practice area may need the reverse. Timed mixed sets are available through our practice test site.
Five-Year Validity and Renewal
The credential is valid for five years. Here is the part that surprises many certificants: renewal is not a continuing-education exercise. Recertification requires:
- Current RD status.
- A new eligibility application, including the applicable specialty-practice hours.
- Payment of the examination fee.
- Another passing specialist examination.
Continuing education alone does not renew CSG. That makes the credential more demanding to maintain than many certifications, and it is worth factoring into any return-on-investment analysis. If your goal is career positioning, the salary guide and CSG jobs overview cover where the credential tends to matter, such as long-term care, post-acute and community aging services, and consulting roles that serve older adults.
Where the Official Reading List Fits
CDR publishes a reference list for the exam, most recently updated for July 2025. Treat it as a reading list rather than a replacement for the content outline: the outline tells you what is tested, and the reference list points to source material. Some listed titles are paid texts, so check what you can access before building your plan around them. Pair the reading list with applied question practice, since reading alone will not train the best-answer decision-making the exam rewards.
Frequently Asked Questions
There are 150 multiple-choice questions, each with one best answer from four options. Of these, 125 are scored and 25 are unscored pretest items. You will not know which are which, so answer every question as if it counts.
The examination fee is USD $350, paid at the time of scheduling. Retesting normally requires reauthorization and a 60-day wait, so a second attempt is both a cost and a delay. See the cost breakdown for the full picture.
Nutrition Assessment, with 55 scored items, followed by Nutrition Interventions with 47 and Foodservice and Food Safety with 23. These are item counts from the content outline, not published percentage weights.
CDR does not publish a fixed raw passing percentage. Passing is established through Angoff standard setting with statistical equating for form difficulty, so it is not a set share of candidates who pass. Focus on competence across all three domains rather than a target number.
No. Renewal after five years requires current RD status, a new eligibility application with the applicable specialty-practice hours, payment of the exam fee, and another passing specialist examination.
For the broader picture of what the credential is and what it signals to employers, start with What Is CSG?, and when you are ready to test your recall under timed conditions, head to the CSG Exam Prep practice tests.