Alexandra Baluna, MD

Dr. Luna Sanchez Rivera holds the position of Staff Psychiatrist at Talkiatry. After completing residency in 2016 at the Ponce Medical School Psychiatry Residency in Puerto Rico, she then moved to North Carolina to complete a subspecialty in Child and Adolescent Psychiatry at Duke University Health System. There, she transitioned into an assistant professor position, focused on structuring pediatric emergency psychiatric services, and helped support the consult and liaison pediatric service. Her years of experience have included working as an integrated care child psychiatrist within outpatient clinics at Duke University Health System, and she trained and worked as a staff psychiatrist at the Inpatient State Facility in North Carolina. She also served in the Dayton Children's Hospital outpatient clinics in Dayton, Ohio, the Appalachian Health System outpatient clinics in Linville, North Carolina, and more recently has been serving the Child and Adolescent inpatient population in Bangor, Maine. Dr. Sanchez Rivera has an approachable style aimed at providing a comprehensive evaluation for all age ranges and is comfortable managing various levels of diagnostic complexities. She provides supportive psychotherapy while using psychodynamic therapy skills to clarify her patient's constellation of symptoms, identify unifying themes and provide thorough psychoeducation throughout the process to drive positive outcomes. She integrates psychodynamic medication management approaches and is adept at family therapy interventions.

Dr. Juliet Nichols has been a diplomate of the American Board of Psychiatry and Neurology since 2002 and has been practicing psychiatry for over 25 years. While an expert in psychopharmacology, Dr. Nichols has an integrative approach to treatment and she often incorporates psychotherapeutic techniques when appropriate, tailoring every treatment to each patient's individual needs. She completed her Psychiatry residency at Stony Brook-SUNY and Geriatric Psychiatry Fellowship at the Albert Einstein School of Medicine. Over the last two decades, Dr. Nichols served as an attending psychiatrist at JT Mather Hospital in Port Jefferson, NY, where she became proficient in delivering stellar psychiatric care in a variety of settings. She specializes in treating adult and geriatric mental illnesses, including: Depression, Anxiety Disorders (eg, OCD, Panic Disorder, GAD, PTSD), ADHD, and Cognitive Disorders in the elderly. Dr. Nichols strives to help her patients gain insights into their inner conflicts, unveil their strengths, accept their limitations, and build their coping skills. Her approach is dynamic, straightforward, and empathic so patients always feel safe, understood, and at ease. She engages the patient to be an active participant in treatment decision-making, creating a strong therapeutic alliance.‍

Jennifer Garner is a board-certified Family Psychiatric Nurse Practitioner with Talkiatry. She obtained a Bachelor of Science in Nursing from the University of Tennessee, Knoxville, in 2009 and a master's degree from Vanderbilt University in 2011. Jennifer enjoys treating all adults and has outpatient experience with community mental health, corrections, and private practice. Besides outpatient care, she has worked in crisis stabilization and ambulatory detox for adults with primary psychiatric and dual diagnosis illnesses. Jennifer is skilled in treating a wide range of conditions including ADHD, bipolar disorder, substance misuse, anxiety, OCD, and PTSD. She is committed to fostering a welcoming and inclusive environment, ensuring all gender identities feel safe and respected. With a focus on patient-centered care, her approach is carefully tailored to each person's individual needs and goals, promoting a collaborative therapeutic relationship. During appointments, she combines medication management with therapy techniques to empower patients with the skills for their well-being. Appointments are as unique as each individual that she meets with. If you're ready (and even if you're not so sure) take the first step and let's talk.

Maegan Roberts, PMHNP, earned her MSN from Indiana University School of Nursing and her BSN from the University of Evansville. She worked as a Registered Nurse in inpatient psychiatry for five years before transitioning to outpatient care as a psychiatric nurse practitioner in 2017. Maegan has experience treating patients across the lifespan, from school-aged children to older adults. She is especially attuned to the challenges of young adulthood, parenting, and navigating complex family dynamics. Committed to lifelong learning, she values the insights and perspectives her patients bring to their care.

Maegan creates a therapeutic environment grounded in dignity, empathy, and respect. She empowers patients through education about diagnoses, symptoms, and medications while promoting autonomy and informed decision-making. Her approach blends psychopharmacology with supportive therapy, skill-building, and sustainable lifestyle strategies, helping patients build insight and resilience.

In the initial appointment, Maegan takes time to understand each patient’s history, concerns, and goals. From there, she collaborates with patients to create and adapt treatment plans that align with their evolving needs, always keeping the individual’s unique context and aspirations at the center of care.

Background and credentials

Dr. Matthew Koller is a board-certified adult psychiatrist who completed his undergraduate training at The University of Texas at Austin. He earned his medical degree from The University of Texas Health Science Center at San Antonio and completed his general adult psychiatry residency at Baylor College of Medicine in Houston, TX, where he served as Chief Resident of Education in his final year of training.

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Treatment approach

Dr. Koller believes that understanding a patient fully is essential before treatment begins, emphasizing a collaborative and patient-centered approach to care. His practice is primarily focused on medication management, but he also incorporates supportive therapy and other therapeutic modalities as needed. He may recommend including a therapist in the treatment plan to ensure comprehensive, well-rounded care. He has experience treating a wide range of mental health conditions, including depression, anxiety, insomnia, personality disorders, bipolar disorder, PTSD, and psychotic disorders.

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What you can expect in a first visit

During the first visit, patients can expect a thorough and individualized psychiatric evaluation, where Dr. Koller takes the time to understand their symptoms, history, and treatment goals. He prioritizes open communication and shared decision-making, working closely with patients to develop personalized treatment plans. While medication management is the foundation of his approach, he remains flexible and adaptive, incorporating therapy and other interventions as needed to help patients achieve optimal mental health.

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Why Talkiatry?

We’re a virtual mental health practice that makes it easy to find great care. We combine quality and convenience to help you thrive—faster. Our providers, like this one, are highly trained experts who specialize in medication management and collaborate with you on a treatment plan that fits your needs and comfort level.

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Cassandra Thomas-Jingles is a dedicated, board-certified Psychiatric Nurse Practitioner with dual certification as a Family Nurse Practitioner. She is deeply passionate about helping others and takes a holistic, evidence-based approach to mental healthcare, empowering patients to live life to their fullest potential.

Her practice focuses on medication management and supportive therapy, offering 30-minute follow-up sessions. When additional therapy is needed, she recommends including a therapist in the care team to ensure the best possible outcomes. With extensive experience in both outpatient and inpatient settings, Cassandra has worked with adults and children facing a wide range of mental health conditions, including ADHD, anxiety, depression, and psychotic disorders. She strongly believes in prioritizing client involvement and fostering interprofessional collaboration.

Your mental health journey is unique, and Cassandra is here to listen with compassion and without judgment. All conversations are confidential, and her goal is to create a safe, welcoming space where you feel comfortable sharing your thoughts and concerns.

During your initial appointment, Cassandra will review your mental health history, current symptoms, lifestyle factors, and any previous treatments to gain a comprehensive understanding of your needs. Together, you will develop a personalized treatment plan that may include therapy, medication, or other supportive strategies. She values shared decision-making, ensuring your input is considered at every step of the process.

If medication is part of your treatment, Cassandra will clearly explain its benefits, potential side effects, and how your progress will be monitored. Adjustments can be made as needed to achieve the best possible outcome.

Healing takes time, and Cassandra is committed to supporting you throughout the process. Follow-up appointments are essential for tracking progress, making necessary adjustments, and ensuring you receive the care you need.

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