How to Become a CNA in North Carolina
North Carolina requires Nurse Aide I listing on the NC Nurse Aide I Registry for nursing home employment. Candidates complete a state-approved training program, then pass the NNAAP exam through Credentia, the state’s contracted testing vendor. The NC DHHS Division of Health Service Regulation maintains the registry. A Nurse Aide II credential is available through the NC Board of Nursing for those who want to expand their scope of practice.
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Nurse Aide I listing is maintained by the NC DHHS Division of Health Service Regulation (DHSR) on the NC Nurse Aide I Registry. It’s required for nursing home work and is the foundation for all higher-level aide credentials. Nurse Aide II builds on that credential and is administered by the NC Board of Nursing. The state also offers Geriatric Aide and Medication Aide certifications for aides seeking further specialization. For full RN and LPN requirements in the state, see North Carolina nursing license requirements.
Use the links below to jump to the credential or process that applies to you.
- Nurse Aide I Training Requirements
- Nurse Aide I Examination Process
- Registry Renewal Requirements
- Geriatric Aide and Medication Aide Certifications
- Nurse Aide II Requirements
- Out-of-State CNAs
Nurse Aide I Training Requirements
To qualify for the Nurse Aide I competency exam, candidates must complete a North Carolina state-approved training program or demonstrate eligibility through an approved alternative route. State-approved programs require a minimum of 75 hours of combined classroom and clinical instruction, with at least 16 hours of hands-on practical training.
Program length varies by school and schedule. Accelerated options can be completed in four to six weeks. Community college programs may run longer depending on their format. A list of state-approved programs is available through the NC DHHS Health Care Personnel Education and Credentialing section.
Candidates who don’t complete an NC program may still qualify to test. Accepted alternative routes include:
- Completion of a nurse aide training program in another state (within the last 24 months, if not currently listed on any state registry)
- Completion of an NC-approved nurse aide refresher program
- Active enrollment in an approved nursing education program
- EMT certification or other qualifying healthcare training
- Military training equivalent to nurse aide competencies
Candidates applying through an alternative route must submit a training waiver application through Credentia’s CNA365 platform. The eligibility determination is made before scheduling is permitted.
Nurse Aide I Examination Process
The North Carolina Nurse Aide I competency evaluation is the National Nurse Aide Assessment Program (NNAAP) exam. As of October 2024, it is developed and managed by Credentia, the state’s contracted testing vendor. Candidates register and schedule through Credentia’s online CNA365 platform at credentia.com/test-takers/ncna.
Exam Format
The NNAAP has two parts: a written or oral knowledge examination and a hands-on skills evaluation. Candidates take both on the same day when testing for the first time. The written version is available in English. The oral version is available in English and Spanish.
The skills evaluation requires candidates to be in full, unrestricted physical condition. Candidates on light duty for medical reasons may take the knowledge exam, but are not permitted to complete the skills evaluation until they provide documentation of clearance to return to unrestricted duty.
Attempt Limits and Deadlines
Candidates must pass both portions of the exam within two years of completing a state-approved training program, or within three attempts, whichever comes first. An unexcused absence counts as an attempt. Candidates who don’t pass within these limits must complete a new training program before retesting.
Scheduling and Fees
Candidates create an account and submit an application through the Credentia CNA365 platform before scheduling is available. Candidates who previously had a Pearson VUE account for NC nurse aide testing need to create a new Credentia account, and existing Pearson VUE data carries over automatically. Testing can take place at a Credentia test center or through online proctoring from home or work.
Exam fees are set by Credentia and are subject to change. North Carolina periodically updates exam fees. Verify current pricing directly with Credentia before registering at credentia.com/test-takers/ncna. Under federal and North Carolina law, nursing homes are required to cover NNAAP exam fees for their nurse aide employees, including the first attempt.
Rescheduling must be done in advance of the exam date. Candidates who fail to reschedule within the required window generally forfeit their fees. Exceptions may be granted for documented emergencies.
Registry Placement
Candidates who pass both evaluations are typically added to the NC Nurse Aide I Registry within two to five business days, excluding weekends and holidays. Registry status can be verified at ncnar.ncdhhs.gov. Name and address changes must be reported promptly to DHHS to avoid delays in renewal notices.
Registry Renewal Requirements
Nurse Aide I registry listings must be renewed every two years. To renew, aides must meet two requirements:
- A minimum of eight hours of paid nursing assistant work performed under RN supervision within the 24-month period
- Signature from the supervising RN on an Employment Verification form confirming that work
Volunteer hours and private-duty employment outside a licensed home health agency do not count toward the employment requirement.
The NC Nurse Aide I Registry generally mails renewal forms to eligible nurse aides approximately three months before expiration, but aides remain responsible for ensuring timely renewal. Registry status can be verified at ncnar.ncdhhs.gov. Aides whose listings expire before renewal is complete must pass the NNAAP exam again to be relisted without completing new training.
Geriatric Aide and Medication Aide Certifications
North Carolina offers two adjunct certifications for Nurse Aide Is who want to specialize. Both require an active NA I status as a prerequisite.
Geriatric Aide Certification
The Geriatric Nurse Aide certification is awarded by DHHS and was developed in response to recommendations from the North Carolina Institute of Medicine Long-Term Care Task Force. It’s not required for nursing home employment, but it extends basic aide training to include dementia care, end-of-life care, stress management, and self-care topics.
Candidates must hold an active Nurse Aide I status and then complete an approved geriatric aide curriculum. A list of approved programs is available through the NC DHHS Health Care Personnel Education and Credentialing section. Community colleges may also offer the curriculum locally.
Medication Aide Certification
The Medication Aide credential allows aides to assume additional medication-administration responsibilities in a nursing home setting. Medication Aide education is overseen by the NC Board of Nursing, while the Medication Aide Registry is maintained by the Division of Health Service Regulation (DHSR). An active NA I credential is required as a starting point.
To qualify, candidates must complete a 24-hour medication aide course approved by the NC Board of Nursing, then pass a Credentia-administered examination. Employers are responsible for verifying registry status and conducting a facility-specific clinical skills evaluation before an aide performs medication tasks. A registered nurse must confirm that the aide can safely perform the specific tasks required at that facility.
Medication aide registry status does not automatically authorize medication administration in all settings. Aides who want to take on this role in an adult care home must seek separate authorization through the Adult Care Licensure Section, which requires its own examination.
Nurse Aide II Requirements
The Nurse Aide II credential is issued by the NC Board of Nursing and authorizes a broader scope of practice than the NA I. It’s classified under unlicensed assistive personnel. To qualify, a Nurse Aide I must complete one of the following pathways:
- Complete an approved NA II training program
- Complete qualifying nursing coursework (the individual nursing school determines which stage of the curriculum meets the NA II standard)
- Document equivalent military training
Accepted military equivalents include completion of an Air Force Medical Service Technician Program, an Army 68W10 Health Care Specialist program, or Navy Basic Corpsman Class A training at the rank of Third Class or higher.
A list of approved NA II programs is available on the NC Board of Nursing website. Initial listing on the NA II Registry costs $24, and renewal requires the same fee. NA II status can only be maintained while NA I listing remains active and in good standing. Nurse aides considering further advancement can review becoming an LPN in North Carolina as a next step.
Out-of-State CNAs
Nurse aides moving to North Carolina from another state must apply for listing on the NC Nurse Aide I Registry. The Medication Aide credential is not awarded by reciprocity, meaning aides certified in another state must meet the NC-specific requirements regardless of prior training.
Out-of-state candidates who completed a nurse aide training program in another state within the last 24 months and are not currently listed on any state registry may be eligible to challenge the NNAAP exam in North Carolina without completing a new training program. Eligibility is determined through the training waiver process on the Credentia CNA365 platform.
Candidates already listed on the NC registry who don’t meet renewal requirements must pass the NNAAP exam before their listing expires to avoid the requirement to complete new training.
Find nursing licensure requirements by state for RNs, LPNs, LVNs, and advanced practice nurses.
Frequently Asked Questions
Who administers the NC Nurse Aide I exam?
Credentia is the state-contracted testing vendor for the NNAAP exam in North Carolina. Candidates register and schedule through Credentia’s online CNA365 platform. Prior to this arrangement, testing was handled by Pearson VUE, so candidates with old Pearson accounts need to create a new Credentia account.
How many times can you take the CNA exam in North Carolina?
Candidates have three attempts to pass both portions of the NNAAP exam within two years of completing a state-approved training program. An unexcused absence counts as an attempt. Candidates who use all three attempts without passing must complete a new approved training program before they can retest.
Can you challenge the CNA test in North Carolina without attending a training program?
Yes, in some circumstances. Candidates with out-of-state nurse aide training completed within the last 24 months, qualifying healthcare training (such as EMT certification), or equivalent military training may apply for a training waiver through the Credentia CNA365 platform. Eligibility is reviewed before scheduling is permitted. Nursing students enrolled in an approved NC program are also eligible to test.
How do you renew your NC Nurse Aide I registry listing?
Registry listings must be renewed every two years. Renewal requires at least eight hours of paid nursing assistant work under RN supervision within the renewal period, plus a completed Employment Verification form signed by the supervising RN. The registry generally mails renewal forms approximately three months before expiration, but tracking your expiration date and submitting documentation on time is your responsibility.
What is the difference between Nurse Aide I and Nurse Aide II in North Carolina?
Nurse Aide I is the entry-level credential required for nursing home work. Listing is maintained by the NC DHHS Division of Health Service Regulation. Nurse Aide II is an advanced credential issued by the NC Board of Nursing that authorizes a broader scope of practice. NA II listing requires active NA I status and completion of an approved program, qualifying nursing coursework, or equivalent military training.
Key Takeaways
- Credentia administers the NC exam — Testing has moved from Pearson VUE to Credentia. Register and schedule at credentia.com/test-takers/ncna using the CNA365 platform.
- Three attempts, two years — Candidates must pass both the knowledge and skills portions of the NNAAP within two years and complete three attempts of a state-approved program.
- Renewal requires paid work — Eight hours of paid nursing assistant work under RN supervision per 24-month cycle, with an Employment Verification form, is required to maintain registry status.
- NC recognizes four credential levels — Nurse Aide I, Nurse Aide II, Geriatric Aide, and Medication Aide. Each has distinct requirements and issuing authorities.
- Challenge exams are available — Candidates with qualifying out-of-state training, healthcare credentials, or military experience may be eligible to test without completing a new NC program.
Select your state below to find approved CNA training programs, application links, and certification requirements for your jurisdiction.