Does a med spa have to register or hold a license in Maine?

Short answer
The cited rules do not settle this — none creates a med spa registration. They do require a level 1 or 2 establishment license at each location where aesthetics or cosmetology is practiced, except for physicians and supervised staff acting within their scope.

Maine licenses the PREMISES and grades them: a person, firm, corporation or other legal entity may not provide services in, operate or cause to be operated a level 1 or level 2 establishment where aesthetics is practiced unless that establishment is licensed by the director, and the license authorizes operation only at the location it was issued for. Individual practice licensure is separate and also required. One boundary is carried here and the other is narrower than it looks. The defined practice of aesthetics does not include the diagnosis, treatment or therapy of any dermatological condition. The medical exemption, by its own words, withholds only the chapter’s prohibitions and penalties from persons authorized to practice medicine and those under their supervision and control, and only when they act within the scope of their profession or occupation — these claims do not establish that it lifts the establishment-license requirement, so a physician-run facility offering aesthetics should confirm that with the director or counsel. These claims survey the barbering and cosmetology chapter and do not report on registration requirements elsewhere in Maine law. Chapter 15 §§4–6, effective July 14, 2026, address compounding and drug shortages. Compounded drugs and IV saline must follow a valid physician, PA or APRN order, rather than a patient-driven menu. A licensed physician must perform compounding in a clinic or office where the compounded solutions are administered, subject to state and federal law. The rule excludes walk-in, mobile and concierge IV services from the USP <797> immediate-use exception, requires documentation supporting elective/nonmedical prescribing during FDA-listed shortages, and makes rule violations grounds for discipline.