Learn more about Judith Pineda-Cardenas, Medical Assistant at Crescendo MD, and her role in supporting patient care with adaptability, attention to detail, and reliability. Judith Pineda-Cardenas Judith is a Medical Assistant with three years of experience working across a variety of departments at Stanford. During that time, she’s built a well-rounded skill set by supporting both clinical care and administrative workflows, and enjoys bringing that versatility to her work with patients and providers. She’s known for being adaptable, detail-oriented, and a reliable part of the care team. Outside of work, Judith loves spending time outdoors with her partner and their dogs, and enjoys quality time with friends and family. CONTACT US BACK

Discover Crescendo MD’s concierge medical services. Offering concierge primary care, pediatrics, opthalmology and allergy care for families seeking premium healthcare solutions in Portola Valley . Crescendo MD Your Partner for Curated Healthcare LEARN MORE Premier Concierge Medicine for Every Stage of Life. Your health journey isn’t something you have to make alone. Founded on empathy and a patient-first model, our medical approach allows for the highest level of access, guidance, and standard of comprehensive coordinated healthcare. Primary Care Crescendo provides elite, membership-based primary care focusing on health optimization for every age and stage of life. Our physicians are available 24/7 wherever patients are in the world. Pediatric Care Experience world-class pediatric care that goes beyond traditional office visits. Enjoy 24/7 access to personalized care tailored to your family’s unique needs. Ophthalmology Our Ophthalmology arm is a boutique pediatric ophthalmology and adult strabismus care practice built around maximizing the development and restoration of one’s innate vision potential. Ophthalmology at Crescendo can be accessed by patients without a Crescendo membership. Allergy Crescendo Allergy & Immunology provides expert, personalized care for children with food and drug allergies, environmental allergies, severe asthma, chronic cough, eczema, hives, allergic rhinitis, conjunctivitis, and other immune conditions, including evaluation for immune deficiencies and life-threatening reactions such as anaphylaxis. Through precise diagnosis, advanced allergy testing, oral and drug challenges, and tailored immunotherapy, we help children live confidently and thrive. Our care is available to both members and non-members, reflecting the highest standard of pediatric allergy care. Meet Our Care Team Our interdisciplinary team is built around designing and delivering personalized health strategies and whole-person care to all of our patients. DOCTORS CARE TEAM

Learn more about Zayra Helu, PCA at Crescendo MD, and discover her commitment to patient care and fostering strong relationships within the Crescendo community. Zayra Helu, PCA Zayra Helu is a highly esteemed Patient Care Advocate and Certified Clinical Medical Assistant at Crescendo MD . When our nursing team requires additional support, Zayra seamlessly deploys her clinical expertise to ensure our patients receive the reliable care they deserve. Her unwavering dedication to the Crescendo MD community is evident in the strong relationships she has cultivated with Dr. Greene’s patients since 2016. Her commitment extends to nurturing connections with all our Crescendo families. Outside her role in pediatric concierge medicine, Zayra, her husband, and their two children, cherish moments spent with their extended families, fostering a profound sense of togetherness in their personal lives. CONTACT US BACK

Learn more about Dr. Alan Greene, an Award-Winning Pediatrician and discover compassionate care focused on your child's well-being. Concierge Pediatrics Alan Greene, MD, FAAP is passionate about primary care pediatrics. He thrives in an environment of collaborative medicine and delights in joining families as they navigate everything from child development to major illnesses to exploring the power of individualized care in childhood to optimize longevity. He is a graduate of Princeton University and the University of California at San Francisco. He completed his pediatric residency at UCSF Benioff Children’s Hospital Oakland. He is an Adjunct Professor of Pediatrics at Stanford University School of Medicine. After completing his training Dr. Greene entered primary care in San Mateo. Many of his patients’ parents were early pioneers in the health and tech areas. They strongly encouraged him to use technology to increase and multiply his ability to care for children. In response to their urging, in 1995 he founded DrGreene.com, which was cited by the AMA as “the pioneer physician website”. Since that time, Dr. Greene has helped shape online health through his involvement with several health and health tech ventures including doc.ai and most recently, DrGreene.ai. In 2012, Dr. Greene joined Private Medical, a membership-based practice, as the first physician in the Silicon Valley office. He was instrumental in their growth until 2021 when he joined the team at Crescendo MD as a founding owner. Dr. Greene is well known for his ability to manage complex cases with great empathy and attention to detail. He is equally well known for his proactive care for well children. He particularly enjoys finding ways his patients can adopt individualized health habits that help them thrive now and build for a long and healthy life. He is a co-founder of the e-Patient movement and served as the founding president of the Society for Participatory Medicine. He is a founding partner of The Collaborative on Health and the Environment and is a board member of The Lundberg Institute. Most recently, he co-founded La Conexión, a not-for-profit organization that links physicians, health technology, and resources from the United States to empower healthcare workers in underserved countries. He is a highly respected speaker and author including his books Feeding Baby Green, Raising Baby Green, From First Kicks to First Steps, and his first children’s book, Flower Moon. CONTACT US BACK Alan Greene, MD

Crescendo MD was founded on a patient-first philosophy, delivering personalized, concierge healthcare with empathy, expert guidance, and comprehensive care for every stage of life. Our Story A Philosophy of Care Rooted in Deep Understanding Crescendo was founded on the belief that exceptional care begins with knowing each patient as a whole person. From the beginning, our physicians have practiced medicine in a way that honors individual histories, goals, risks, and personal circumstances. This commitment shapes every decision we make and forms the core of our precision medicine model. Our team brings together years of clinical experience caring for patients across all stages of life. This collective expertise represents the level of care many seek from concierge medicine doctors in Portola Valley and throughout the San Francisco Bay Area. An Environment Designed for Calm, Privacy, and Ease Our practice was created to feel both elevated and familiar. We want patients and families to feel at ease from the moment they walk in, supported by a serene environment and a team that knows them well. Every member of our staff is approachable, warm, and attentive, creating a sense of comfort that is as essential to us as the clinical excellence behind our care. This atmosphere reflects the way we believe medicine should feel. It should be calm, personal, and genuinely welcoming. A Lifelong Approach to Longevity and Wellbeing Optimizing health with a focus on longevity is a central part of our work and one that reflects our long-standing commitment to proactive health. We view wellbeing as a lifelong journey shaped by consistent habits in nutrition, movement, sleep, emotional resilience, and strong social connections. Our physicians, including apply advanced diagnostics and technology to identify early risk factors, guide interventions, and support healthier, more energetic years. This approach is grounded in ongoing review of the medical literature and direct clinical experience, ensuring that recommendations remain current, thoughtful, and supported by evidence. Guidance Through the Complexities of Modern Healthcare We also understand that much of what challenges patients today is not clinical care itself but the complexity of modern healthcare systems. Our physicians and staff have spent years helping individuals and families manage these barriers. We coordinate specialist access, resolve insurance issues, arrange testing, oversee transitions of care, and support those who require services in the home. By handling these details directly, we reduce stress and allow our members to focus on their health rather than the obstacles. Comprehensive Expertise Across All Stages of Life For us, concierge medicine is defined by close involvement in every stage of care. Our physicians are trained in pediatrics, internal medicine, acute care, and preventive health, which allows us to manage a wide range of concerns without quickly deferring to outside providers. This versatility helps patients avoid unnecessary emergency visits and hospitalizations. It ensures that care remains continuous, coordinated, and centered on the needs of each individual and family. Care for Individuals Who Expect Excellence and Discretion We are privileged to serve individuals and families who value a high level of medical oversight and individualized attention. Many of our members include leaders in technology, finance, philanthropy, and the arts, along with high performance individuals and athletes who depend on expert care and complete discretion. Their trust reflects the depth of the relationships we build and our commitment to delivering care that is both comprehensive and highly personal. A Practice Continually Advancing, With a Purpose That Endures CrescendoMD continues to evolve, supported by ongoing education, clinical collaboration, and a dedication to staying ahead of advances in medicine. Our purpose remains constant. We aim to provide careful, informed, and truly individualized care that strengthens health today and supports vitality for the years ahead Join CrescendoMD Today!

Elevate your healthcare with concierge primary care in Palo Alto. Crescendo MD provides personalized medicine designed around you. Concierge Care in Palo Alto Area Exceptional Access. Precision Medicine. A Partnership Built for Long-Term Health. CrescendoMD delivers concierge medicine in the Palo Alto area for individuals and families seeking a comprehensive, thoughtful, and proactive medical experience. A limited patient panel ensures that time and attention are never constrained. A Philosophy of Care Rooted in Deep Understanding Our model is founded on the belief that smaller patient panels allow for a higher standard of care. The CrescendoMD team each contributing expertise across pediatrics, adult medicine, integrative care, acute care, allergy and immunology, and ophthalmology. What Concierge Medicine Means at CrescendoMD Palo Alto patients often navigate demanding personal and professional environments. Our structure allows us to understand each person's health in full context. Traditional clinics rely on fast-paced visits that limit a physician’s ability to identify subtle changes or address complex issues. Long-term relationships allow for earlier recognition, better prevention, and more precise planning. Smaller patient panels enable immediate availability, close monitoring, and continuity across every stage of care. How Our Approach Differs from Traditional Primary Care Many clinics in Palo Alto are structured around high patient volumes and short appointment times. CrescendoMD offers a more thoughtful and comprehensive approach. Time for meaningful care Appointments allow for unhurried discussion and detailed evaluation. Personalized prevention and precision medicine Care plans integrate risk patterns, lifestyle, and long-term health goals. Continuous physician involvement We guide diagnostics, follow-up, specialist communication, and transitions of care. Direct communication with your physician Members can reach us easily for support, updates, and urgent questions. Whole-family medical support Our training spans pediatrics, preventive medicine, acute care, and adult medicine. Early recognition and proactive planning Strong relationships allow concerns to be identified sooner. The Experience of Care Our practice environment is designed to feel calm, familiar, and elevated. Patients experience a space that strengthens trust, comfort, and clarity. Membership Includes • Extended visits • 24 hour direct access to physicians • Comprehensive preventive assessments • Advanced diagnostics and longevity evaluations • Specialist navigation and coordination • Support for home-based care • Care for all ages • Direct communication for questions and urgent needs Who We Serve Our members in the Palo Alto area include innovators, researchers, founders, philanthropists, and high-performance individuals who value discretion, accuracy, and reliable physician guidance. Why Palo Alto Patients Choose CrescendoMD Patients choose CrescendoMD because they want a long-term partnership with a physician who understands their full medical history and personal goals. They value clarity, responsiveness, and an approach rooted in prevention and continuity. CrescendoMD provides a level of care designed to support health today and strengthen it for the future.

Get answers to common questions about Crescendo MD, including membership, services, access to care, and how our personalized, concierge healthcare works. Frequently Asked Questions What is concierge medicine and how is Crescendo different from a traditional primary care practice? Concierge medicine is a membership model that allows a physician to care for a very small number of patients. Unlike traditional clinics where schedules are full and rushed, our model is centered on direct communication, continuity, and thoughtful shared decision making. How many patients does each doctor manage at Crescendo? Each physician cares for no more than 100 members, allowing time for thoughtful visits, same- day scheduling, and the ability to manage concerns in a thorough and unhurried way. How do I reach my doctor and how quickly will I hear back? Members have direct access to a physician at all times. Communication is immediate and care begins right away. Our model removes the usual barriers found in larger systems, so questions, updates, and urgent issues are handled promptly. How frequent are doctor check-ups? Care does not just begin when you reach out, but is ongoing and proactive. Our team reviews the care plan of every single patient on a weekly basis, so we are thinking of your health even when you aren’t thinking about it. Visits may be scheduled in the office, virtually, or through a house call when requested. This model allows us to provide timely help whether you are local, live outside the immediate area or traveling. What types of medical concerns can you manage? Our primary-care physicians have broad training in pediatrics, family medicine, and emergency medicine. This allows us to manage a wide range of routine, preventive, and acute issues in our clinic. Many problems that would otherwise lead to an urgent care or emergency room visit can be safely evaluated and treated in our office. What does preventive and longevity medicine mean at Crescendo? We believe that optimal medical care should begin long before chronic illness appears. Our approach moves away from the traditional reactive model, where problems are addressed only after disease develops. Instead, we focus on identifying risks early, understanding the whole picture of your health, and creating a plan that supports long-term vitality. This includes advanced screening, careful monitoring over time, and guidance tailored to your lifestyle, genetics, and personal goals. Is longevity medicine only for adults? No. Longevity begins well before adulthood, as many of the foundations for lifelong health are established in childhood and adolescence. At Crescendo, we view preventive and longevity- oriented care as a continuum that spans all ages. We focus on healthy habits, development, metabolic balance, cardiovascular risk, sleep, nutrition, physical conditioning, and emotional well-being across the lifespan. By watching these factors closely and addressing early signals of risk, we help prevent chronic disease before it starts and support long-term vitality from the earliest years onward. What is included in the annual membership? Membership includes direct access to your physician, comprehensive annual evaluation, coordination of extensive blood and screening panels, vaccinations (other than certain travel vaccines), and all in-office blood draws. You also receive a medication kit for home and travel along with annual medical evacuation coverage through MedJet. How are consultations with specialists managed? Our Patient Care Advocate team secures next available appointments with leading specialists. We work directly with VIP services at Stanford, UCSF, and other elite institutions throughout the country and maintain close relationships with top consultants. We use the term expert network intentionally. Our physicians have broad training and manage a wide range of medical issues directly, using consultants as true experts rather than default destinations. Do you have any in-house specialists? Yes, we have also welcomed associate specialists to our team, including pediatric ophthalmology and allergy. These are internationally recognized experts in fields that are often difficult to access in the community, selected for their exceptional expertise and commitment to providing the highest level of care. What if I am traveling or live outside the Bay Area? Digital medical instruments are made available that allow accurate remote assessments. These tools make virtual visits more effective and help maintain continuity of care when you are away. This supports our ability to manage both preventive and acute issues wherever you are. Additionally, members receive a curated medication kit for home and travel, refreshed yearly. MedJet medical evacuation coverage is also included, providing protection should a serious emergency occur while abroad. Combined with our clinical breadth, this creates a sense of confidence and comfort whether you are in the neighborhood or across the world. Do you accept insurance? Your membership fee covers direct access and services provided by our practice. Laboratory testing is billed to your insurance. Prescriptions, radiology studies and any services performed outside our office are also billed through insurance or paid directly to the specialty clinic providing them. We coordinate these appointments and help streamline the process, but the costs for those services follow standard insurance or provider billing practices. How do I know if a Crescendo membership is right for me? An introductory meeting gives you a chance to meet the physician, discuss your needs, and learn how our model supports your health goals. Many patients choose this model because they want a true ongoing relationship with a physician who knows them well and is available whenever they need care. We encourage prospective patients to explore all of their options, and if our model is not the best fit, we are always happy to recommend practices that may better meet their needs.

Learn more about Lorena Torres, PCA at Crescendo MD, whose decade of patient care expertise ensures compassionate support and seamless navigation for families in healthcare. Lorena Torres, PCA Lorena Torres, a seasoned Patient Care Advocate and Certified Phlebotomist at Crescendo MD , brings over a decade of valuable patient care expertise to her role. Her journey into patient-first care began as a caretaker, where she found a fulfilling balance of compassion and professionalism while assisting patients, their families, and medical teams. In 2013, Lorena completed a Patient Care Navigation Program at San Jose City College, marking the inception of her professional voyage in the medical field. Her subsequent involvement in the non-profit health sector further enriched her patient care skills and professional leadership capabilities. When not working in concierge medicine she enjoys working out and spending time with her family. CONTACT US BACK

Meet Dr. Natalie Pageler, a board-certified pediatrician and clinical informaticist, dedicated to innovative, compassionate care for children and families. Natalie Pageler, MD Pediatrics Dr. Natalie Pageler is a board-certified pediatrician, intensivist and clinical informaticist, who is a nationally recognized leader in pediatric clinical informatics. She has cared for children and families for over 20 years, combining compassionate bedside care with innovative approaches to improving the patient and family experience and outcomes. Dr. Pageler completed her undergraduate degree in Engineering Physics at the University of Arizona, before going on to Stanford for medical school, pediatric residency, and pediatric critical care fellowship. She also completed a masters in medical education through the University of Cincinnati, where her thesis on the use of computerized clinical decision support to inform best practices for clinicians. After completing her training, Dr. Pageler served on faculty in the pediatric intensive care unit at Stanford Children's Health, which gave her not only advanced expertise in managing complex medical issues, but also the ability to calmly and adeptly navigate emergencies, as well as a deep respect for the resilience of patients and families. Dr. Pageler also served as Chief Health Informatics Officer at Stanford Children's for a decade, where she led digital transformation efforts to advance compassionate, patient-centered care enabled by cutting-edge technology. She co-founded the Stanford Clinical Informatics Fellowship, the first of its kind in the nation, to train the next generation of healthcare leaders in the applications of advanced technology to improve the quality of healthcare. In addition to her clinical practice at Crescendo MD, Dr. Pageler continues to serve as Associate Dean and Division Chief of Clinical Informatics at Stanford, where she leads efforts to harness technology and data to improve children’s health. She continues to drive advances in patient engagement, digital health, and artificial intelligence in pediatrics and to train and mentor the next generation of physician leaders. Dr. Pageler is especially passionate about partnering with families to support children and teens as they grow — from routine health and wellness, to sports medicine, to the complex developmental and emotional needs of adolescents. Her practice reflects her belief that the best care comes from a trusted, ongoing relationship that provides personalized attention and innovative, data-driven, proactive care to help children grow into healthy, thriving adults. Outside of medicine, Dr. Pageler enjoys cycling, gardening, fine wines, and traveling with her husband and three sons. CONTACT US BACK

Learn more about Dr. Alan Gianotti, a seasoned physician at Crescendo MD, and discover personalized primary care focused on your health and wellness goals. Alan Gianotti, MD, MS, ABEM Concierge Adult Primary Care Alan Gianotti, MD, MS, ABEM brings a wealth of training, experience, and perspective to his medical practice at Crescendo MD. Dr Gianotti embraces an approach to exceptional care that begins with truly knowing his patients. In a quiet, unhurried setting, he has the time and the commitment to understand their lifestyles, their goals and what really matters to optimize their health. His clinical foundation is rigorous and wide-ranging: a microbiology degree from the University of Notre Dame; a medical degree from the University of Oregon; residency training from Stanford University; and years of practice at both Sutter and Stanford University Medical Center. His clinical acumen began as a Fulbright Scholar in infectious disease and was further refined through disaster relief & expedition medicine throughout the Himalayas. These experiences have nurtured a calm, seasoned judgment that comes from caring for people in genuinely demanding circumstances. Dr Gianotti is appreciated by his patients for his clinical expertise, problem solving and empathetic nature. His practice is also shaped by a lifetime of experience on both sides of human performance. His history as a Division I collegiate soccer player, an Ironman triathlete and a Himalayan mountaineer has informed his approach to fitness, recovery, injury prevention and more importantly healthy aging and longevity. Beyond the practice, Dr. Gianotti serves on advisory boards for the Painted Turtle Camp — Paul Newman's camp for children with serious illnesses, and Andean Health & Development, reflecting a commitment to care that extends well beyond the exam room. He lives in Palo Alto with his wife, two adventurous daughters, and his golden retriever. CONTACT US BACK

Experience exceptional concierge pediatrics care services in Portola Valley. At Crescendo MD, we prioritize your health with personalized medical attention. CONCIERGE PEDIATRICS Elevated, Comprehensive Pediatric Care Pediatrics at Crescendo is built around personalized care that supports your child in everyday life, not just during visits. With direct around-the-clock access, available when you need us, Pediatrics at Crescendo is designed to fit into your family’s life. Our model is simple: exceptional medicine, direct 24/7 access, and care that supports your child to thrive. Whether your family is at home, traveling, or living across multiple residences, your pediatrician remains continuously available and fully engaged. A Pediatric Experience Without Compromise Crescendo MD offers a level of pediatric care rarely found outside major academic centers, delivered with the intimacy and responsiveness of a private physician. Your family can expect: Direct access to a dedicated pediatrician Private, unhurried visits in office or at home 24/7 global availability, including urgent guidance and after-hours support Comprehensive care coordination across leading pediatric subspecialists and children’s hospitals, including Stanford, UCSF, Boston Children’s, CHOP, and other top centers An unwavering commitment to excellence and confidentiality for families who want unsurpassed care. This is pediatric care elevated—thoughtful, proactive, relationship-driven, and crafted around your family’s life. Quiet, Confident Pediatric Care No shared waiting rooms Direct relationships with your physicians Collaboration with pediatric subspecialists across Stanford Children’s, UCSF, Boston Children’s, CHOP, and other centers A practice designed for privacy and thoughtful, attentive medicine We care for families who could receive care anywhere and who choose a model that values discretion, clarity, and clinical excellence. At Crescendo, our world-class pediatricians care for a limited number of families so that every child receives personalized attention, unhurried visits, and care that reflects the unique needs of each family. INQUIRE Your Pediatric Care Team Meet the physicians leading our Pediatrics clinic, delivering personalized care and tailored solutions for your child’s growth. Alan Greene, MD Senior Partner Pediatrics Alan Greene, MD, FAAP is passionate about primary care pediatrics and delights in joining families to explore the power of individualized care in childhood to optimize longevity. Read More Janesta Noland, MD Senior Partner Pediatrics Janesta Noland, MD, FAAP, brings deep experience in personalized care of children to the Crescendo team, providing outstanding, personalized care to her patients and their families. Read More Natalie Pageler, MD Pediatrics Dr. Natalie Pageler is a board-certified pediatrician, intensivist and clinical informaticist, who is a nationally recognized leader in pediatric clinical informatics.lies. Read More

Learn more about Salvador Galvan, Certified Ophthalmic Assistant at Crescendo MD, and his role in supporting patient care with a calm, reassuring approach. Salvador Galvan Salvador Galvan is a Certified Ophthalmic Assistant and Optician with 15 years of experience in eye care, including 10 years in pediatric ophthalmology and 5 years in adult retinal ophthalmology. Known for his friendly and reassuring approach, Salvador helps patients feel comfortable while guiding them through diagnostic testing, imaging, and treatment explanations. His ability to connect with both children and adults makes him a trusted presence in diverse clinical settings. In addition to his ophthalmic experience, Salvador earned his Associate of Science degree in Fire Technology in 2009. His background in emergency preparedness has strengthened his calm, steady communication style and his ability to support patients in stressful or unfamiliar situations. Outside of his professional role, Salvador enjoys spending time with his family, playing sports, and staying active through regular workouts. CONTACT US BACK