This study explored the current medical nutrition therapy (MNT) provided to adult patients undergoing hematopoietic stem cell transplantation (HSCT) and examined the current and desired role of registered dietitians (RDs) in providing MNT. A total of 60 RDs (57% response rate) responded to an electronic questionnaire. Descriptive statistics and χ(2) analyses (SPSS; version 18) were used. Results revealed the primary form of diet was oral, and for patients on nutrition support, parenteral nutrition (PN) was used more frequently (16%-31%) than enteral nutrition (EN) (5%-9%; P ≤ .05). Nutrition support decisions were based on patients' individualized needs rather than established protocol or policies. Mucositis was the most common reason for implementing PN (31%), and intubation or being in the intensive care unit was the most common reason for implementing EN (28%). The RDs had varying degrees of autonomy in order writing and were most often recommending MNT to the physician or writing the MNT order with a physician cosignature. Many RDs reported desiring higher autonomy than what they were currently practicing (P < .05). Those who held a certified specialist in oncology (CSO) or certified nutrition support dietitian/clinician (CNCD/C) certification were significantly more likely to have and desire greater autonomy in order writing than those without specialty credentials (P ≤ .05). No difference was found in current practice or desired autonomy based on the years of experience or educational degree.