Ensora (TheraNest) Alternatives for Private-Pay Therapists in 2026

If you signed up for TheraNest a few years ago, the product you are logging into now has a different name, a different owner, a different pricing model, and as of this summer a new AI system. None of that is necessarily bad. It does mean the comparison you did when you chose it is out of date.

Here is what actually changed, and what to weigh if you run a private-pay practice.

The rename, in order

TheraNest launched in 2008 as an independent, mental-health-focused EHR. In May 2021, private equity firm KKR acquired its parent, Therapy Brands. In April 2025, Therapy Brands rebranded to Ensora Health, and TheraNest now sits under Ensora Mental Health.

The thing worth noticing is not the name. It is the scope. Ensora now spans five therapy disciplines, mental health alongside speech-language pathology, physical therapy and occupational therapy, across TheraNest and Fusion, serving over 200,000 providers.

That scale buys real things: engineering depth, integrations, a support organization. It also means you are one discipline inside a much larger roadmap.

What it costs now

Ensora moved to per-therapist pricing, with new plans available from August 2025. As of its pricing page, last updated September 17, 2026:

Telehealth is $12 per therapist per month on Essentials and included in Premier. The free trial gives you Premier features for 21 days.

One detail that matters more than the table. Existing customers keep the pricing they signed up on. If you have been on TheraNest for years, what you pay may have little to do with what is published, in either direction. Check your own invoice before you compare anything.

Read the tiers as a private-pay therapist and a pattern shows up. Most of what separates Advanced and Premier from Essentials is insurance machinery: claims processing, eligibility checks, billing automation. If you never file a claim, the upgrade path is largely selling you things you will not open.

Ensai, the part that is actually new

On July 30, 2026, Ensora announced Ensai, one AI system across all five disciplines and both platforms. It has three parts:

• Session Assistant records a session and drafts a note. Paid add-on.
• Notes Enhancement polishes documentation the clinician already wrote. Free in TheraNest.
• Ensai Support answers questions about the platform.

Most of it rolls out gradually through fall 2026, so what is switched on in your account may trail the press release. Worth asking your rep rather than assuming.

Two honest observations.

The free Notes Enhancement tier is a genuine improvement and it changes the old criticism. It used to be fair to say TheraNest charged for any AI at all. That is no longer true. What remains true is that the recording scribe, the part that saves the most time, is still a paid add-on on every tier including the $89 Premier plan.

And Ensora's stated privacy terms are better than much of this market. Its announcement says sessions are recorded only with explicit consent from both clinician and client, recordings are deleted within 24 hours after note generation, client data never trains AI models, and PHI is never sold. Compare that to competitors who reserve the right to retain de-identified transcripts to improve their own features, and Ensora is on the careful end. Credit where it is due.

So what are the alternatives

The useful way to sort these is not by feature count. It is by what you are actually buying.

If you bill insurance at volume, Ensora Premier or TherapyNotes are built for that, and leaving would cost you infrastructure you use every week. Most alternatives are a downgrade for you.

If you want a platform, not a tool, and you value a company with scale and a long product roadmap, Ensora's size is a feature. So is SimplePractice's.

If you want an ambient scribe above all, Upheal and the standalone scribe tools do that one job and integrate with what you already have. You do not have to change EHR to change how notes get written.

If you are private pay and want to stop paying for a claims engine, the calculation is different. What you need is scheduling, notes, telehealth, payments, a portal and assessments. What you do not need is the half of the product that exists to talk to payers.

That last case is what CoralEHR is built for. It has no claims engine, no ERA or eligibility workflow, and no insurance billing, deliberately. Starter is $29 a month and AI-free. Professional is $79 with optional AI that drafts from a typed scratchpad rather than a recording, which means there is no microphone in the room and no transcript to consent to. Practice pricing starts at $35 per clinician for groups of 6+, custom above that.

If you bill insurance, that missing claims engine is disqualifying and you should stay where you are. If you do not, it is the point.

Before you switch anything

1. Pull your actual invoice. Grandfathered pricing makes published tiers close to meaningless for long-time customers.
2. Add up the add-ons you would really enable, not the ones in the marketing table. Telehealth, planners, the scribe, extra admin seats.
3. Ask what happens to your data on the way out, in writing, and in what format. Ask this before you need the answer.
4. Decide the recording question first. Whether your AI listens to the room or works from your typing drives your consent obligations and, in some states now, your legal ones. We wrote separately about which states regulate AI in therapy.
5. Trial it during a real week, not a quiet one.

Sources: Ensora Health company overview · Ensora Mental Health pricing (last updated September 17, 2026) · Ensai launch announcement, July 30, 2026

Figures were read from the linked pages on September 20, 2026. Pricing and AI availability are both moving right now. Confirm current terms with Ensora before deciding anything.