Medical Terminologies MCP
README.md
# Medical Terminologies MCP Server
[](https://www.npmjs.com/package/medical-terminologies-mcp)
[](https://www.npmjs.com/package/medical-terminologies-mcp)
[](https://www.npmjs.com/package/medical-terminologies-mcp)
[](https://registry.modelcontextprotocol.io)
[](https://lobehub.com/mcp/sidneybissoli-medical-terminologies-mcp)
[](https://smithery.ai/servers/sidneybissoli/medical-terminologies-mcp)
[](https://glama.ai/mcp/servers/SidneyBissoli/medical-terminologies-mcp)
[](https://codeguilds.dev/packages/medical-terminologies-mcp)
[](https://github.com/SidneyBissoli/medical-terminologies-mcp)
[](https://github.com/sponsors/SidneyBissoli)
[](https://medical.sidneybissoli.com/stats)
[](https://modelcontextprotocol.io)
[](https://opensource.org/licenses/MIT)
A Model Context Protocol (MCP) server providing unified access to major global medical terminologies:
- **ICD-11** - International Classification of Diseases (WHO)
- **LOINC** - Logical Observation Identifiers Names and Codes
- **RxNorm** - Normalized names for clinical drugs (NIH)
- **MeSH** - Medical Subject Headings (NLM)
- **ATC** - Anatomical Therapeutic Chemical classification (WHO Collaborating Centre, served via NLM RxClass)
- **CID-10** - Brazilian Portuguese translation of ICD-10 (DataSUS V2008, bundled)
🇧🇷 [Leia em Português](LEIA-ME.md)
## See it in action
Ask your assistant:
- *"What's the ICD-11 code for type 2 diabetes?"* → `icd11_search`
- *"Map ICD-10 code E11 to ICD-11."* → `map_icd10_to_icd11`
- *"What does LOINC 2339-0 measure?"* → `loinc_details`
- *"Qual o código CID-10 para infarto agudo do miocárdio?"* → `cid10_search`
The answers come from authoritative sources (WHO, NLM, NIH, DataSUS) — real codes and mappings, not guesses from training data.
## Features
- 33 tools: 31 terminology tools plus `search`/`fetch` for ChatGPT Deep Research
- 3 MCP **Prompts** that orchestrate tool calls into named workflows (`find-medical-code`, `drug-info`, `cid10-portuguese-lookup`) — clients render these as one-click user actions
- 4 MCP **Resources** for in-process reference content (`info://server`, `info://cid10/chapters`, `info://licenses`, `info://stats`) — sub-millisecond reads (except `info://stats` which round-trips to the StatsCounter Durable Object on the hosted endpoint)
- Multi-terminology support in a single server
- Cross-terminology mapping and search
- **Provenance on every response** (since v1.8.0): each successful tool result carries a machine-readable provenance block — source, canonical URL, data vintage, real extraction instant (cache hits keep the original fetch instant), ready-to-use citation, and license — in `structuredContent.provenance` + `attribution`, mirrored in `_meta` under `com.sidneybissoli.medical/*`, with a compact text footer for text-only clients. Multi-source responses (`find_equivalent`, `validate_codes`) carry one block per source; server-computed ranking fields are flagged as derived
- Built-in caching for improved performance
- Rate limiting to respect API limits
- Detailed responses with rich formatting
- Two transports: **stdio** (default; for Claude Desktop, IDE clients) and **Streamable HTTP** (the hosted Cloudflare Worker at `https://medical.sidneybissoli.com/mcp`, or your own instance of `worker/`)
📖 **Article (in Portuguese):** [CID-10, CID-11 e o que muda para quem trabalha com dados do SUS](docs/artigo-cid10-e-cid11-no-sus.pt-BR.md) — the V2008 structure in numbers, what the WHO transition tables are and are not, and the licences that differ between sources. Also published on the site, in Portuguese and English: [sidneybissoli.com](https://sidneybissoli.com/en/blog/posts/cid10-cid11-sus/).
## Who is this for?
This server is **not** a clinical-care decision tool — practicing clinicians have specialized assistants (UpToDate AI, OpenEvidence, EHR-integrated tools) for that. The actual audience is researchers, public-health analysts, clinical informatics developers, and educators who need programmatic access to authoritative terminology data.
| If you're a... | Start with | Why |
|----------------|------------|-----|
| **Biomedical researcher / bibliographer** | `mesh_search`, `mesh_descriptor`, `mesh_tree` | MeSH is PubMed's indexing vocabulary; tree numbers let you traverse the controlled hierarchy programmatically |
| **Public-health analyst (Brazil / SUS)** | `cid10_search`, `cid10_chapters`, `atc_classify` | CID-10 V2008 is the Brazilian operational standard; ATC pairs cleanly with DataSUS prescription data |
| **Public-health analyst (international)** | `icd11_search`, `icd11_lookup`, `icd11_chapters` | WHO ICD-11 is the current international revision; chapters and hierarchy support pipeline classification |
| **Clinical-informatics developer** | `loinc_search`, `loinc_details`, `find_equivalent` | LOINC for lab/observation interoperability; cross-terminology search to scaffold new mappings |
| **Educator / curriculum author** | `mesh_descriptor`, `icd11_lookup`, `rxnorm_search` | Authoritative definitions, tree numbers, and drug term-types you can drop into self-checked exercises |
## What this server is not intended for — and what leaves your machine
- **It is not intended for clinical decision support.** It retrieves what the official sources publish. It does not diagnose, recommend treatment or dose.
- **It is not designed to run offline.** ICD-11, LOINC, RxNorm, MeSH and ATC are answered live by the public WHO and NLM APIs. **Every query string you send is forwarded to those services.** De-identify term lists before running them: no patient names, free-text notes or record identifiers. Two datasets are bundled and answered in-process, with no network call: **CID-10** (DataSUS V2008) and the **WHO ICD-10 → ICD-11 transition tables** (`map_icd10_to_icd11`).
- **Credentials are not required on the hosted endpoint.** `https://medical.sidneybissoli.com/mcp` has WHO credentials configured. `WHO_CLIENT_ID`/`WHO_CLIENT_SECRET` are needed only when you run the server yourself, and only for the 5 ICD-11 tools.
- **SNOMED CT is not served.** It was retired in 2.0.0: no public Snowstorm host remains, SNOMED content needs a per-country license, and the off-by-default tools confused every catalog that listed this server. See [SNOMED CT (retired in 2.0.0)](#snomed-ct-retired-in-200).
- **It is not OMOP-shaped.** Results carry the source's own codes, not OMOP `concept_id`s, and there is no `concept_ancestor` traversal. If your output has to join against an OMOP CDM, use an OMOP vocabulary service; use this server for general terminology work.
- **Search is lexical, not semantic.** `find_equivalent` and the `*_search` tools match words, not meanings (no embeddings).
- **Large batches are paced by the upstream rate limits** (see [API Rate Limits](#api-rate-limits)). Thousands of distinct terms take minutes to tens of minutes.
## Reproducibility: which version answered
A crosswalk or a coded dataset is only meaningful against a stated vocabulary version. Two things record it:
- **`terminology_versions`** lists the release each terminology is queried against. Call it at the start of a batch run and keep the output with your results. The ICD-11 release is **pinned** (default `2026-01`, override with `WHO_ICD11_RELEASE_ID`), so a self-hosted run is repeatable until you change it.
- **The provenance block on every response** (`structuredContent.provenance`) carries `retrieved_at` (the real extraction instant; a cache hit keeps the original fetch time), the source URL, the citation and the license. Its `data_vintage` field carries the version **when the source exposes one**:
| Source | `data_vintage` in each response |
|--------|----------------------------------|
| ICD-11 | the pinned WHO release (e.g. `2026-01`) |
| ICD-10 → ICD-11 tables | the bundled WHO release (e.g. `2025-01`) |
| CID-10 | `V2008` |
| LOINC, RxNorm, MeSH, ATC | `null`, because these APIs do not state a release per response. Record `terminology_versions` + `retrieved_at` instead |
Minimal batch log: one `terminology_versions` call at the start, plus the `provenance` of each result (source, `data_vintage`, `retrieved_at`).
## Try the hosted instance (no install)
A public Cloudflare Workers deployment runs at:
```
https://medical.sidneybissoli.com/mcp
```
Connect via the MCP Inspector or any Streamable HTTP MCP client:
```bash
npx @modelcontextprotocol/inspector --transport streamable-http \
--server-url https://medical.sidneybissoli.com/mcp
```
Or install via Smithery, which proxies the same endpoint through their gateway:
```bash
npx -y smithery mcp add sidneybissoli/medical-terminologies-mcp
```
The hosted instance has WHO credentials configured, so all 33 tools work without any setup on your side. For your own deployment (e.g. corporate network, different region, custom WHO credentials), see the [Installation](#installation) and [Hosted on Cloudflare Workers](#hosted-on-cloudflare-workers-primary) sections below.
## Installation
### Global Installation (Recommended)
```bash
npm install -g medical-terminologies-mcp
```
### Local Installation
```bash
npm install medical-terminologies-mcp
```
## Configuration
### Claude Desktop
Add to your Claude Desktop configuration file:
**macOS**: `~/Library/Application Support/Claude/claude_desktop_config.json`
**Windows**: `%APPDATA%\Claude\claude_desktop_config.json`
```json
{
"mcpServers": {
"medical-terminologies": {
"command": "npx",
"args": ["-y", "medical-terminologies-mcp"],
"env": {
"WHO_CLIENT_ID": "your-who-client-id",
"WHO_CLIENT_SECRET": "your-who-client-secret"
}
}
}
}
```
### Environment Variables
| Variable | Required | Description |
|----------|----------|-------------|
| `WHO_CLIENT_ID` | Yes¹ | WHO ICD API Client ID |
| `WHO_CLIENT_SECRET` | Yes¹ | WHO ICD API Client Secret |
| `WHO_ICD11_RELEASE_ID` | No | ICD-11 release to query (e.g. `2025-01`, `2026-01`). Default `2026-01`. |
| `LOG_LEVEL` | No | pino log level (`debug`, `info`, `warn`, `error`, `fatal`). Default `info`. |
¹ Required for ICD-11 tools. Get credentials at: https://icd.who.int/icdapi.
LOINC, RxNorm, MeSH, ATC and CID-10 need no configuration.
### HTTP transport (hosted)
The server runs over stdio by default — that's what Claude Desktop and IDE clients expect. The Streamable HTTP transport is served by the Cloudflare Worker in `worker/` (an instance of the maintainer's Fase 0 hosting template). The `--http` flag of the Node entry was removed in v1.6.0 — if you need a local HTTP endpoint, run the Worker locally:
```bash
npm ci && cd worker && npm ci
npm run dev # wrangler dev on http://localhost:8787
# Inspector via HTTP
npx @modelcontextprotocol/inspector --transport streamable-http --server-url http://localhost:8787/mcp
```
Hosted endpoints (production and local alike):
- `POST /mcp` — JSON-RPC over Streamable HTTP (the MCP protocol). Stateless mode: each request is independent.
- `GET /health` — liveness probe returning `{ status, name, version, tool_count, uptime_s }`.
- `GET /status` — version + deploy metadata. `GET /metrics` — aggregated per-tool usage.
- `GET /stats` and `GET /stats/badge` — public tool-call counter (since 2026-05-13) and its shields.io badge.
- `GET /.well-known/mcp/server-card.json` — static server card for registry scanners.
- CORS is permissive (`*`) so browser clients (e.g. the MCP Inspector web UI) can connect directly.
### ChatGPT (Deep Research)
ChatGPT deep research (and company knowledge, and research workflows over the Responses API) only uses an MCP server that exposes exactly `search` and `fetch` — this server does, on top of the terminology tools. Point the connector at the hosted endpoint, no key required:
```
https://medical.sidneybissoli.com/mcp
```
`search` ranks the query across the bundled CID-10 (categories, subcategories, chapters), the terminology version records and a live fan-out to ICD-11, LOINC, RxNorm and MeSH (the same fan-out `find_equivalent` does; a source that fails is skipped) and returns `{ id, title, url }`; `fetch` renders the document through the terminology's own lookup tool (`cid10_lookup`, `icd11_lookup`, `loinc_details`, `rxnorm_concept`, `mesh_descriptor`, `terminology_versions`) as readable Markdown with the canonical public page (WHO ICD browsers, loinc.org, RxNav, MeSH Browser), which is what ChatGPT cites. Both carry the same provenance block as every other tool — `search` one block per source that answered, like `find_equivalent`. In ChatGPT's developer mode (Settings → Security and login → Developer mode) any tool is callable — the terminology tools remain the ones to use for data.
### Hosted on Cloudflare Workers (primary)
The production deployment is the Cloudflare Worker in `worker/`, config in `worker/wrangler.jsonc`, CI deploy in `.github/workflows/deploy-worker.yml` (auto-runs on every push to `main`).
To deploy your own instance:
```bash
npm ci && npm run build:worker-lib
cd worker && npm ci
npx wrangler login # one-time, browser flow
npx wrangler deploy # publishes to <name>.<account>.workers.dev
# Set ICD-11 secrets so those 5 tools work:
npx wrangler secret put WHO_CLIENT_ID
npx wrangler secret put WHO_CLIENT_SECRET
```
Note: `worker/wrangler.jsonc` pins the maintainer's `account_id` and custom domain route — remove/replace both for your own deployment.
Why Workers: zero cold start at the edge, $5/mo flat for 10M requests (free tier covers up to 100k req/day), and no VMs to size or restart. The template ships per-IP rate limiting and a usage-stats Durable Object; the upstream-facing cache/rate-limiter are per-isolate (PROGRESS.md Phase 11.9 Stage 2 tracks the KV/DO upgrade).
### Listing on Smithery
After your Worker is live, register the URL on Smithery:
1. Visit https://smithery.ai → **Publish → MCP** (or `https://smithery.ai/new`).
2. Pick the **URL** submission path (Smithery deprecated container hosting in 2024 — URL is the supported flow now).
3. Paste `https://<your-worker>.workers.dev/mcp`. Smithery's gateway scans for compliance and proxies traffic.
## Available Tools (33)
### Official Portuguese (pt-BR) content
The server never machine-translates terminology content — but several sources publish official translations, and the tools expose them:
- **CID-10 is natively Portuguese**: `cid10_search` / `cid10_lookup` / `cid10_chapter(s)` serve the DataSUS V2008 dataset (the CID-10 the Brazilian SUS uses operationally).
- **ICD-11 in official Portuguese**: pass `language: "pt"` to `icd11_search` / `icd11_lookup` to search and read WHO's official pt-BR linearization labels.
- **MeSH**: pass `language: "pt"` to `mesh_search` / `mesh_descriptor` to request NLM's official translations where they exist.
If a source has no official translation for an entry, you get the source language back — never a machine translation.
### ICD-11 Tools (5)
| Tool | Description | Example |
|------|-------------|---------|
| `icd11_search` | Search ICD-11 by term | `query: "diabetes mellitus"` |
| `icd11_lookup` | Get entity details by code/URI | `code: "5A11"` |
| `icd11_hierarchy` | Navigate parent/child relationships | `code: "5A11"` |
| `icd11_chapters` | List all ICD-11 chapters | - |
| `icd11_postcoordination` | Get postcoordination axes | `code: "5A11"` |
### LOINC Tools (4)
| Tool | Description | Example |
|------|-------------|---------|
| `loinc_search` | Search lab tests and observations | `query: "glucose"` |
| `loinc_details` | Get full LOINC code details | `loinc_num: "2339-0"` |
| `loinc_answers` | Answer list of a questionnaire item: LA code, text, order and score (PHQ-9 items: 0-3); empty for codes without a list, "not found" for unknown codes | `loinc_num: "44250-9"` |
| `loinc_panels` | Panel/form structure: member items in form order | `loinc_num: "44249-1"` |
### RxNorm Tools (5)
| Tool | Description | Example |
|------|-------------|---------|
| `rxnorm_search` | Search drugs by name | `query: "metformin"` |
| `rxnorm_concept` | Get drug concept details | `rxcui: "6809"` |
| `rxnorm_ingredients` | Get active ingredients | `rxcui: "6809"` |
| `rxnorm_classes` | Get therapeutic classes | `rxcui: "6809"` |
| `rxnorm_ndc` | Map between RxCUI and NDC | `rxcui: "6809"` |
### MeSH Tools (4)
| Tool | Description | Example |
|------|-------------|---------|
| `mesh_search` | Search MeSH descriptors | `query: "hypertension"` |
| `mesh_descriptor` | Get descriptor details | `mesh_id: "D006973"` |
| `mesh_tree` | Get tree hierarchy location | `mesh_id: "D006973"` |
| `mesh_qualifiers` | Get allowed qualifiers | `mesh_id: "D006973"` |
### Crosswalk Tools (4)
| Tool | Description | Example |
|------|-------------|---------|
| `map_icd10_to_icd11` | Authoritative ICD-10 → ICD-11 mapping via bundled WHO transition tables; returns primary code + chapter + URIs and any WHO-documented alternatives | `icd10_code: "E11"` |
| `validate_codes` | Batch-validate up to 50 codes across ICD-11, LOINC, RxNorm, MeSH, ATC, CID-10; returns per-code valid/invalid + display name | `codes: [{terminology:"icd11",code:"5A11"}, …]` |
| `find_equivalent` | Ranked unified search across terminologies: server-computed `match_score`/`rank` per candidate plus cross-terminology `groups` of lexically identical titles | `term: "diabetes"` |
| `harmonize_terms` | Batch-map up to 50 free-text terms to standard codes: diagnosis → ICD-11, drug → RxNorm (+ ATC classes), lab → LOINC. Per term: ranked candidates with `match_score` and `match_type` (`exact` / `strong` / `needs_review`), one provenance block per source. The term-first companion of `validate_codes` | `terms: [{term:"type 2 diabetes",domain:"diagnosis"}, {term:"metformin",domain:"drug"}]` |
### ATC Tools (3)
WHO Anatomical Therapeutic Chemical classification, served through NLM RxClass (free, no auth). The WHOCC base itself requires a paid subscription, but RxClass envelopes the same code/name pairs.
| Tool | Description | Example |
|------|-------------|---------|
| `atc_classify` | Drug name → ATC code(s) | `drug_name: "metformin"` |
| `atc_lookup` | ATC code (level 1-4) → name + level type | `atc_code: "A10BA"` |
| `atc_members` | ATC class → member drugs | `atc_code: "A10BA"` |
### CID-10 Tools (4)
Brazilian Portuguese translation of ICD-10 (DataSUS V2008). Bundled as a static dataset — no HTTP calls. The Brazilian SUS uses CID-10 V2008 operationally; for the international ICD-11 (current WHO revision), use the ICD-11 tools above.
| Tool | Description | Example |
|------|-------------|---------|
| `cid10_search` | Portuguese text search (diacritic-insensitive, AND between words; everyday words resolved to CID-10 wording, and the response says so) | `query: "câncer de mama"` |
| `cid10_lookup` | Code → official Portuguese name | `code: "I21"` or `"A00.1"` |
| `cid10_chapters` | List the 22 CID-10 chapters | - |
| `cid10_chapter` | Chapter detail with constituent groups | `num: 9` |
**Ask in your words, not the CID-10's.** The CID-10 is worded in clinical Portuguese, and `cid10_search` matched your words against the code title as one verbatim phrase — so the everyday word returned *nothing at all*. Measured over the 14,496 categories and subcategories of the bundled V2008 dataset (2026-09-16), fixed since 1.12.0: every word must match (AND), and the everyday word is expanded to the CID-10's own (`src/clients/cid10-vocabulary.ts`, measured pairs only) — the response says so in `vocabulary_notes`, and zero results come with a way out.
| you ask | hits before | the CID-10 writes | hits |
| --- | ---: | --- | ---: |
| `câncer`, `câncer de mama` | 0 | neoplasia maligna (da mama) | 497, 12 |
| `ataque cardÃaco` | 0 | infarto | 42 |
| `AVC` | 0 | acidente vascular cerebral | 11 |
| `pressão alta` | 0 | hipertensão | 44 |
| `dor de cabeça` | 0 | cefaleia | 10 |
| `suicÃdio` | 0 | lesão autoprovocada | 167 |
| `atropelamento` | 0 | pedestre traumatizado | 97 |
| `aids` | 0 | doença pelo HIV | 45 |
| `pedra nos rins`, `convulsão`, `tabagismo`, `maconha`, `crack`, `obeso`, `cachorro` | 0 | calculose, convulsões, fumo, canabinóides, cocaÃna, obesidade, provocado por cão | 19, 41, 17, 12, 13, 6, 11 |
What the V2008 dataset does not carry stays out and still returns zero — `covid` (U07.1 is from 2020), `zika` — because an alias for a code that does not exist promises what the source does not have. The same table feeds the Deep Research `search` index.
### Versioning Tools (2)
Surface what version of each terminology this server queries against today — useful when running batch validation against a pinned release or when investigating an unexpected lookup miss after an upstream update.
| Tool | Description | Example |
|------|-------------|---------|
| `terminology_versions` | List all 8 supported terminologies with current version, release date, publisher, source URL, and update cadence | - |
| `terminology_diff` | Report what diff data is available between two versions of a terminology (real cross-revision stats for ICD-10 → ICD-11; guidance otherwise) | `terminology: "icd10-icd11"` |
### ChatGPT Deep Research (2)
The OpenAI Deep Research contract — the only two tools without a terminology prefix (names fixed by OpenAI). See [ChatGPT (Deep Research)](#chatgpt-deep-research) above.
| Tool | Description | Example |
|------|-------------|---------|
| `search` | Searches the catalog (CID-10, ICD-11, LOINC, RxNorm, MeSH, terminology versions) and returns `{ id, title, url }` ranked by relevance | `query: "myocardial infarction"` |
| `fetch` | Returns the full document of an id from `search` (`{ id, title, text, url, metadata }`), rendered by the terminology's lookup tool | `id: "cid10:I21.0"` |
## Example Outputs
The samples below are the actual formatted output the tools produce — the text body of the `CallToolResult`. Tools also return a `structuredContent` object matching each tool's `outputSchema` for programmatic consumers.
### `loinc_search` — query: "glucose", max_results: 3
```markdown
## LOINC Search Results for "glucose"
Found 1024 total results (showing 3):
1. **74790-7** - Glucose challenge (hydrogen breath test) panel - Exhaled gas
Component: Glucose challenge panel | Method: -
2. **104708-3** - Deprecated Estimated average glucose [Moles/volume] in Blood
Component: Estimated average glucose | Property: SCnc
3. **97510-2** - Glucose measurements in range out of Total glucose measurements during reporting period
Component: Glucose measurements in range/Total glucose measurements | Property: NFr | Method: Calculated
```
`total_count` (1024) reflects every match in the NLM Clinical Tables index, not just the page returned. Bump `max_results` (max 50) to see canonical codes like `2339-0` (Glucose [Mass/volume] in Blood); the API's relevance ranking puts panels and derived measurements above plain blood-glucose at small page sizes.
### `rxnorm_ingredients` — rxcui: "6809" (metformin)
```markdown
# Ingredients for RxCUI 6809
Found 18 ingredient(s):
| RxCUI | Name | Type |
|-------|------|------|
| 6809 | metformin | Single Ingredient |
| 1007411 | chlorpropamide / metformin | Multiple Ingredient |
| 1043562 | metformin / saxagliptin | Multiple Ingredient |
| 1243019 | linagliptin / metformin | Multiple Ingredient |
| 1486436 | dapagliflozin / metformin | Multiple Ingredient |
| 1545149 | canagliflozin / metformin | Multiple Ingredient |
| 1664314 | empagliflozin / metformin | Multiple Ingredient |
| 729717 | metformin / sitagliptin | Multiple Ingredient |
| ... | (10 more combinations) | Multiple Ingredient |
```
For an RxCUI that is itself an ingredient (TTY=IN), the tool returns that ingredient plus every multi-ingredient (TTY=MIN) concept that includes it. Use this to enumerate combination products built around a substance.
### `mesh_descriptor` — mesh_id: "D006973" (Hypertension)
```markdown
# Hypertension
MeSH ID: D006973
## Scope Note
Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more.
## Tree Numbers
- C14.907.489
## Concepts
- Hypertension *(preferred)*
## Allowed Qualifiers
35 qualifier(s) allowed. Use mesh_qualifiers for details.
```
The scope note comes from the descriptor's *preferred concept*, not its annotation field (which is an indexer-facing note). Tree numbers are the navigable path into MeSH's controlled hierarchy — `C14.907.489` places Hypertension under Cardiovascular Diseases → Vascular Diseases.
## Common Workflows
- **ICD-11 lookup:** `icd11_search` with a clinical term → pick the result → `icd11_lookup` with the code for full details, or `icd11_hierarchy` to walk parents/children.
- **Drug pipeline:** `rxnorm_search` for a brand or generic name → `rxnorm_concept` for the canonical record → `rxnorm_ingredients` and `rxnorm_classes` for downstream analysis.
- **Harmonize a column of free-text terms:** `terminology_versions` once at the start → `harmonize_terms` in batches of up to 50 (each term with its domain) → accept `exact`, spot-check `strong`, send `needs_review` to a person → keep each row's `provenance` with the crosswalk. Write lab terms with specimen and property ("glucose serum"): a bare "glucose" matches over a thousand LOINC codes.
- **Cross-terminology scaffolding:** `find_equivalent` with a clinical term searches ICD-11, LOINC, RxNorm and MeSH in one call. Use it to bootstrap mappings; the pairwise `map_*` tools refine them.
- **ICD-10 → ICD-11 (authoritative):** `map_icd10_to_icd11` reads the bundled WHO transition tables. It returns the primary ICD-11 code plus any WHO-documented alternatives, and `null` (never a guess) when the ICD-10 category is not in the table.
## SNOMED CT (retired in 2.0.0)
Until 1.18.x this server shipped five SNOMED CT tools (`snomed_search`, `snomed_concept`, `snomed_hierarchy`, `snomed_descriptions`, `snomed_ecl`) plus `map_snomed_to_icd10`, all off by default behind `ENABLE_SNOMED_TOOLS`, and `map_loinc_to_snomed` (guidance only). Version 2.0.0 removed all seven, the Snowstorm client and the flag, and `snomed` is no longer an accepted value of `find_equivalent`, `validate_codes`, `terminology_versions` or `terminology_diff` (a request naming it gets a validation error listing the accepted values).
Why: the public IHTSDO Snowstorm host behind the tools has returned HTTP 410 since 2026-05; SNOMED CT content needs a license that depends on the user's country; usage was zero; and the half-present terminology misled every third-party catalog that described this server.
If you need SNOMED CT: [`pacharanero/sct`](https://github.com/pacharanero/sct) serves it locally from your own licensed release, and FHIR terminology servers (e.g. `tx.fhir.org`, a public HL7 test server; CSIRO Ontoserver) expose `$lookup`/`$expand` — under your own SNOMED license.
## Terminology Licenses
The MIT license covers the server code and server-maintained metadata
only — **not** the terminology content served through it, and **not**
the two bundled datasets (`cid10.json`, `icd10-to-icd11.json`), which
remain under their own terms. The consolidated notice ships with the
package as [NOTICE.md](./NOTICE.md); every tool response carries a
per-source provenance block with the applicable license.
### ICD-11 (WHO)
ICD-11 content is provided under the [Creative Commons Attribution-NoDerivatives 3.0 IGO license (CC BY-ND 3.0 IGO)](https://creativecommons.org/licenses/by-nd/3.0/igo/), per the [ICD-11 Terms of Use and License Agreement](https://icd.who.int/en/docs/icd11-license.pdf).
- Required citation: *"International Classification of Diseases, Eleventh Revision (ICD-11), World Health Organization (WHO) 2019 https://icd.who.int/browse11. Licensed under the Creative Commons Attribution-NoDerivatives 3.0 IGO licence (CC BY-ND 3.0 IGO)."*
- This server always serves ICD-11 codes and titles together with their URIs, verbatim; non-English labels are WHO's own official translations (never machine-translated)
- WHO may terminate the license at any time by notice (§4.7)
- API access requires registration at https://icd.who.int/icdapi
### WHO ICD-10 → ICD-11 transition tables (bundled)
Format conversion (TSV → JSON, content unaltered) of the tables WHO publishes within the ICD-11 release. © World Health Organization, under the ICD-11 Terms of Use — not under this project's MIT license. WHO's guidance: the tables show correspondence between revisions and *"are not intended for directly converting data from one revision to the other."*
### CID-10 V2008 (DataSUS / CBCD, bundled)
© World Health Organization; Brazilian Portuguese translation © CBCD / Faculdade de Saúde Pública da USP; electronic files published by DataSUS (Ministério da Saúde do Brasil). DataSUS/CBCD permission: developers may use the files **with due credit and at no charge** — this server serves them free with credit in every response. Not under this project's MIT license.
### LOINC
This material contains content from LOINC (http://loinc.org). LOINC is copyright © Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license at http://loinc.org/license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
- Served via the free NLM Clinical Tables API; every code comes with its official display name
- Terms with third-party copyright are served with their notice passed through verbatim
### RxNorm
RxNorm is produced by the U.S. National Library of Medicine; the RxNav APIs serve non-proprietary, public-domain RxNorm content free of charge.
> This product uses publicly available data from the U.S. National Library of Medicine (NLM), National Institutes of Health, Department of Health and Human Services; NLM is not responsible for the product and does not endorse or recommend this or any other product.
### ATC (via NLM RxClass)
ATC classification © WHO Collaborating Centre for Drug Statistics Methodology (https://atcddd.fhi.no/), retrieved via NLM RxClass and served verbatim. This server never redistributes the WHOCC ATC/DDD index.
### MeSH
MeSH is a U.S. government work served under the [NLM Terms and Conditions](https://www.nlm.nih.gov/databases/download/terms_and_conditions.html). Courtesy of the U.S. National Library of Medicine.
## API Rate Limits
This server implements rate limiting to respect API providers:
| API | Rate Limit |
|-----|------------|
| WHO ICD-11 | 5 requests/second |
| NLM (LOINC, MeSH) | 10 requests/second |
| RxNorm | 20 requests/second |
## Development
### Building from source
```bash
git clone https://github.com/SidneyBissoli/medical-terminologies-mcp.git
cd medical-terminologies-mcp
npm install
npm run build
```
### Running locally
```bash
npm start
```
### Testing with MCP Inspector
```bash
npx @modelcontextprotocol/inspector node dist/index.js
```
## Contributing
Contributions are welcome! Please feel free to submit a Pull Request.
1. Fork the repository
2. Create your feature branch (`git checkout -b feature/AmazingFeature`)
3. Commit your changes (`git commit -m 'Add some AmazingFeature'`)
4. Push to the branch (`git push origin feature/AmazingFeature`)
5. Open a Pull Request
## Author
**Sidney Bissoli**
- GitHub: [@SidneyBissoli](https://github.com/SidneyBissoli)
## License
This project is licensed under the MIT License - see the [LICENSE](LICENSE) file for details.
Note: While this software is MIT licensed, the medical terminologies accessed through it have their own licenses (see [Terminology Licenses](#terminology-licenses) above).
## Acknowledgments
- [WHO](https://www.who.int/) for the ICD-11 API
- [Regenstrief Institute](https://loinc.org/) for LOINC
- [U.S. National Library of Medicine](https://www.nlm.nih.gov/) for RxNorm and MeSH
- [Anthropic](https://www.anthropic.com/) for the Model Context Protocol
## Support
If you encounter any issues or have questions:
- Open an issue on [GitHub](https://github.com/SidneyBissoli/medical-terminologies-mcp/issues)
- Check existing issues for solutions
---
Made with love for the medical informatics community
TDQS
A3.9/5.0
Scored across 33 tools
Disambiguation4/5
Tools are well-partitioned by terminology prefix (icd11_*, cid10_*, loinc_*, rxnorm_*, mesh_*, atc_*), and descriptions explicitly add 'when NOT to use' notes. Minor overlap remains between atc_classify/rxnorm_classes (both describe drug classes) and among the cross-terminology search trio (search, find_equivalent, harmonize_terms), plus the easy-to-swap cid10_chapter vs cid10_chapters pair.
Naming Consistency4/5
Dominant pattern is {terminology}_{action} (icd11_search, loinc_details, rxnorm_concept, mesh_tree) which is highly predictable. Deviations are the bare 'search'/'fetch' pair and the cross-terminology verbs (find_equivalent, harmonize_terms, validate_codes) that lack a namespace prefix, but overall conventions are coherent.
Tool Count4/5
33 tools is on the heavy side, but the scope spans seven vocabularies plus mapping utilities, and each terminology carries a proportionate 3-5 tool surface (search/lookup/detail/hierarchy). The bolted-on search/fetch pair for the Deep Research contract adds two tools that aren't domain-specific.
Completeness4/5
Coverage is broad and lifecycle-complete for each terminology (search, lookup, details, hierarchy), plus mapping (map_icd10_to_icd11), validation, harmonization, and cross-terminology equivalence. Minor gaps: no reverse ICD-11→ICD-10 mapping and no standalone international ICD-10 lookup distinct from the Brazilian CID-10 surface.
Maintenance
ActivityActive
ResponsivenessWithin a week