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United States · Certification exam

NBCOT certification: the OTR and COTA credentials

Passing an exam from the National Board for Certification in Occupational Therapy (NBCOT) earns you national certification as an Occupational Therapist Registered (OTR) or a Certified Occupational Therapy Assistant (COTA). NBCOT certification isn’t a license to practice. NBCOT’s Certification Exam Handbook says 50 states, Guam, Puerto Rico and the District of Columbia currently require initial NBCOT certification for occupational therapy regulation, such as licensing, but the license itself comes from the state board.

  • OTR or COTAThe credential you earn
  • 11States accepting it for continuing education
  • Active in Good StandingStatus you need to use the letters
Where to study

Updated October 2026 · Written from official sources, listed at the bottom of this page

How do you earn NBCOT certification?

  • Graduate from an accredited program, or be approved through NBCOT’s eligibility process if you trained abroad.
  • Agree to NBCOT’s Candidate/Certificant Code of Conduct and pass its character review.
  • Pass the OTR or COTA exam. NBCOT then emails your digital certificate, badge and wallet card, and your certification number is in MyNBCOT.
Who is eligible →How results arrive →The NBCOT COTA exam →

Who can use the OTR and COTA letters

  • Active in Good Standing: you’re certified and meet the renewal requirements, so you can call yourself an OTR or COTA and use the letters after your name.
  • Retired in Good Standing: you asked NBCOT for this status while still active, and you can use “OTR, Retired” or “COTA, Retired.”
  • Expired: you didn’t renew by your date or failed an audit, and you can’t call yourself an OTR or COTA or use the letters until NBCOT reinstates you.

Using an NBCOT certification mark when you aren’t actively certified breaks Principle 9 of NBCOT’s Code of Conduct. Certified practitioners must also tell NBCOT about any criminal, legal or disciplinary matter within 60 days.

NBCOT certification renewal →

NBCOT certification and your state license

NBCOT says its certification is independent of any state’s law or licensure. NBCOT says almost all jurisdictions, including the District of Columbia and Puerto Rico, regulate occupational therapists and assistants in some way, and practicing without a license or permit is against the law, so you apply to each state where you want to work. NBCOT publishes a list of state board contacts.

You can use the same professional development for certification and your license. These 11 states accept current NBCOT certification as one way to meet their continuing education rules for license renewal:

  • Alaska
  • Colorado
  • Maine
  • Maryland
  • Mississippi
  • Nevada
  • New Hampshire
  • Oregon
  • South Carolina, where NBCOT certification is required for licensure
  • South Dakota
  • Vermont
NBCOT state board contact list (PDF) ↗Check a certification →
Sources: NBCOT and 4 more. Checked October 2026.

Rules and fees can change, so check the official site before your test.

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