diff --git a/src/__tests__/baselines/version-stamp-comments.json b/src/__tests__/baselines/version-stamp-comments.json
index fc64b4a07..278f68243 100644
--- a/src/__tests__/baselines/version-stamp-comments.json
+++ b/src/__tests__/baselines/version-stamp-comments.json
@@ -1,7 +1,7 @@
 {
   "$comment": "Comment lines that open with a release version, per file under src/. Maintained by src/__tests__/version-stamp-ratchet.test.ts.",
   "count": 2892,
-  "total": 9220,
+  "total": 9216,
   "entries": {
     "__tests__/account-payload-consumer-guard.test.ts": 2,
     "__tests__/acting-account-boundary-guard.test.ts": 7,
@@ -1963,10 +1963,10 @@
     "lib/doctor-report-helpers.ts": 1,
     "lib/doctor-report-pdf-core.ts": 4,
     "lib/doctor-report-pdf/clinical-records-notes-section.ts": 6,
-    "lib/doctor-report-pdf/header-profile-section.ts": 3,
+    "lib/doctor-report-pdf/header-profile-section.ts": 2,
     "lib/doctor-report-pdf/measurements-charts-section.ts": 3,
     "lib/doctor-report-pdf/medication-mood-wellness-section.ts": 7,
-    "lib/doctor-report-types.ts": 21,
+    "lib/doctor-report-types.ts": 20,
     "lib/doctor-report/__tests__/leaf-gating-sweep.test.ts": 1,
     "lib/doctor-report/clinical-records.ts": 2,
     "lib/doctor-report/collect.ts": 4,
diff --git a/src/__tests__/share-view-leaf-render-guard.test.ts b/src/__tests__/share-view-leaf-render-guard.test.ts
index bd50f93f0..6dba245a7 100644
--- a/src/__tests__/share-view-leaf-render-guard.test.ts
+++ b/src/__tests__/share-view-leaf-render-guard.test.ts
@@ -59,7 +59,7 @@ function emptyReport(): DoctorReportData {
       end: "2026-01-31T00:00:00.000Z",
     },
     patient: {
-      username: null,
+      name: null,
       dateOfBirth: null,
       gender: null,
       heightCm: null,
@@ -156,11 +156,10 @@ const DISPOSITIONS: Record<StructuredLeafId, Disposition> = {
     kind: "rendered",
     data: {
       patient: {
-        username: "shared-account",
+        name: "A. Patient",
         dateOfBirth: "1979-04-02T00:00:00.000Z",
         gender: "FEMALE",
         heightCm: 171,
-        fullName: "A. Patient",
       },
     },
     marker: "A. Patient",
diff --git a/src/app/c/[token]/__tests__/report-download.test.ts b/src/app/c/[token]/__tests__/report-download.test.ts
index b52bbf05c..228857a33 100644
--- a/src/app/c/[token]/__tests__/report-download.test.ts
+++ b/src/app/c/[token]/__tests__/report-download.test.ts
@@ -97,7 +97,7 @@ function report(): DoctorReportData {
       end: "2026-01-31T00:00:00.000Z",
     },
     patient: {
-      username: null,
+      name: null,
       dateOfBirth: null,
       gender: null,
       heightCm: null,
diff --git a/src/components/clinician/__tests__/clinician-view-locales.test.tsx b/src/components/clinician/__tests__/clinician-view-locales.test.tsx
index 4fa3094b9..75980ba2f 100644
--- a/src/components/clinician/__tests__/clinician-view-locales.test.tsx
+++ b/src/components/clinician/__tests__/clinician-view-locales.test.tsx
@@ -42,11 +42,10 @@ const FULL_RECORD = {
     end: "2026-01-31T00:00:00.000Z",
   },
   patient: {
-    username: "shared-account",
+    name: "A. Patient",
     dateOfBirth: "1980-01-01T00:00:00.000Z",
     gender: "FEMALE",
     heightCm: 170,
-    fullName: "A. Patient",
   },
   practiceName: null,
   measurements: {},
diff --git a/src/components/clinician/__tests__/clinician-view.test.tsx b/src/components/clinician/__tests__/clinician-view.test.tsx
index da8a4a3f3..7b16bb750 100644
--- a/src/components/clinician/__tests__/clinician-view.test.tsx
+++ b/src/components/clinician/__tests__/clinician-view.test.tsx
@@ -27,7 +27,7 @@ function makeReport(
       end: "2026-01-31T00:00:00.000Z",
     },
     patient: {
-      username: "tester",
+      name: "tester",
       dateOfBirth: null,
       gender: null,
       heightCm: null,
diff --git a/src/components/clinician/identity-sections.tsx b/src/components/clinician/identity-sections.tsx
index 9dfef4aef..3eacd8e81 100644
--- a/src/components/clinician/identity-sections.tsx
+++ b/src/components/clinician/identity-sections.tsx
@@ -56,7 +56,7 @@ export function PatientIdentitySection({
   fmtDate: (iso: string) => string;
 }) {
   const patient = report.patient;
-  const name = patient.fullName ?? patient.username ?? null;
+  const name = patient.name;
   const genderKey = patient.gender
     ? GENDER_LABEL_KEYS[patient.gender]
     : undefined;
diff --git a/src/lib/__tests__/account-name.test.ts b/src/lib/__tests__/account-name.test.ts
index 3d080ebb1..99e0ff3cc 100644
--- a/src/lib/__tests__/account-name.test.ts
+++ b/src/lib/__tests__/account-name.test.ts
@@ -1,6 +1,6 @@
 import { describe, expect, it } from "vitest";
 
-import { accountName } from "../account-name";
+import { accountName, nameInitials, patientName } from "../account-name";
 
 describe("accountName", () => {
   it("names the account by its display name when one is set", () => {
@@ -19,3 +19,41 @@ describe("accountName", () => {
     expect(accountName({ username: "jdoe" })).toBe("jdoe");
   });
 });
+
+describe("patientName", () => {
+  const own = {
+    username: "jdoe",
+    displayName: null,
+    fullName: null,
+    managedProfileAt: null,
+  };
+  const managed = {
+    username: "managed-3f9a0c1d2e3f4a5b6c7d8e9f0a1b2c3d4e5f",
+    displayName: null,
+    fullName: null,
+    managedProfileAt: new Date("2026-01-01T00:00:00.000Z"),
+  };
+
+  it("prefers the full name, then the display name, then the login", () => {
+    expect(
+      patientName({ ...own, fullName: "Jane Doe", displayName: "Jane" }),
+    ).toBe("Jane Doe");
+    expect(patientName({ ...own, fullName: "  ", displayName: "Jane" })).toBe(
+      "Jane",
+    );
+    expect(patientName(own)).toBe("jdoe");
+  });
+
+  it("never prints a managed record's generated login", () => {
+    expect(patientName({ ...managed, displayName: "Robin" })).toBe("Robin");
+    expect(patientName(managed)).toBeNull();
+  });
+});
+
+describe("nameInitials", () => {
+  it("takes the first letter of the first two words", () => {
+    expect(nameInitials("Jane Doe")).toBe("JD");
+    expect(nameInitials("max.mustermann")).toBe("MM");
+    expect(nameInitials("Robin")).toBe("R");
+  });
+});
diff --git a/src/lib/__tests__/doctor-report-pdf-core.test.ts b/src/lib/__tests__/doctor-report-pdf-core.test.ts
index 081dd0a57..4547d92e5 100644
--- a/src/lib/__tests__/doctor-report-pdf-core.test.ts
+++ b/src/lib/__tests__/doctor-report-pdf-core.test.ts
@@ -27,7 +27,7 @@ function makeData(overrides?: Partial<DoctorReportData>): DoctorReportData {
       end: "2026-05-03T12:00:00.000Z",
     },
     patient: {
-      username: "testuser",
+      name: "testuser",
       dateOfBirth: "1985-06-15T00:00:00.000Z",
       gender: "MALE",
       heightCm: 182,
@@ -1003,12 +1003,11 @@ describe("doctor-report emergency first page", () => {
 });
 
 describe("extracted doctor-report section boundaries", () => {
-  it("header/profile prefers the legal name and renders insurance identity", async () => {
+  it("header/profile prints the resolved name and renders insurance identity", async () => {
     const data = makeData({
       patient: {
         ...makeData().patient,
-        fullName: "Ada Lovelace",
-        username: "ignored-handle",
+        name: "Ada Lovelace",
         insurerName: "Example Health",
       },
     });
@@ -1022,7 +1021,6 @@ describe("extracted doctor-report section boundaries", () => {
     });
     const text = await extractText(bytes);
     expect(text).toContain("Ada Lovelace");
-    expect(text).not.toContain("ignored-handle");
     expect(text).toContain("Example Health");
     expect(text).toContain("A123456789");
   });
diff --git a/src/lib/account-name.ts b/src/lib/account-name.ts
index 2340acaa6..7e39c7319 100644
--- a/src/lib/account-name.ts
+++ b/src/lib/account-name.ts
@@ -11,3 +11,31 @@ export function accountName(user: {
   const displayName = user.displayName?.trim();
   return displayName ? displayName : user.username;
 }
+
+/**
+ * The name a clinical document gives a person: the full name when one is
+ * set, the display name next, the login last. A managed record's login is a
+ * handle generated when the record was created (`managed-<hex>`), not a name
+ * anybody chose, so it never prints; with no other name the line is left out.
+ */
+export function patientName(user: {
+  username: string;
+  displayName: string | null;
+  fullName: string | null;
+  managedProfileAt: Date | null;
+}): string | null {
+  const fullName = user.fullName?.trim();
+  if (fullName) return fullName;
+  const displayName = user.displayName?.trim();
+  if (displayName) return displayName;
+  return user.managedProfileAt ? null : user.username;
+}
+
+/** Up to two letters for an avatar, from a name such as `accountName()`. */
+export function nameInitials(name: string): string {
+  return name
+    .split(/[\s._-]+/)
+    .slice(0, 2)
+    .map((s) => s[0]?.toUpperCase() ?? "")
+    .join("");
+}
diff --git a/src/lib/doctor-report-pdf-core.ts b/src/lib/doctor-report-pdf-core.ts
index ad1d366a7..3a511be97 100644
--- a/src/lib/doctor-report-pdf-core.ts
+++ b/src/lib/doctor-report-pdf-core.ts
@@ -164,7 +164,7 @@ export function buildDoctorReportPdfDocument(
     title: t("doctorReport.title"),
     subject: t("doctorReport.subtitle"),
     creator: "HealthLog",
-    author: data.patient.fullName ?? data.patient.username ?? "HealthLog",
+    author: data.patient.name ?? "HealthLog",
   });
   const pageWidth = doc.internal.pageSize.getWidth();
   const pageHeight = doc.internal.pageSize.getHeight();
diff --git a/src/lib/doctor-report-pdf/__tests__/activity-effect-sections.test.ts b/src/lib/doctor-report-pdf/__tests__/activity-effect-sections.test.ts
index 85587fa4d..9ccd51995 100644
--- a/src/lib/doctor-report-pdf/__tests__/activity-effect-sections.test.ts
+++ b/src/lib/doctor-report-pdf/__tests__/activity-effect-sections.test.ts
@@ -97,7 +97,7 @@ function data(overrides: Partial<DoctorReportData> = {}): DoctorReportData {
       end: "2026-05-03T12:00:00.000Z",
     },
     patient: {
-      username: null,
+      name: null,
       dateOfBirth: null,
       gender: null,
       heightCm: null,
diff --git a/src/lib/doctor-report-pdf/__tests__/header-profile-gender.test.ts b/src/lib/doctor-report-pdf/__tests__/header-profile-gender.test.ts
index ce126d2b5..db5846db6 100644
--- a/src/lib/doctor-report-pdf/__tests__/header-profile-gender.test.ts
+++ b/src/lib/doctor-report-pdf/__tests__/header-profile-gender.test.ts
@@ -32,8 +32,7 @@ function renderPatientLines(gender: string | null): string[] {
     doc,
     data: {
       patient: {
-        username: "testuser",
-        fullName: null,
+        name: "testuser",
         dateOfBirth: null,
         gender,
         heightCm: null,
diff --git a/src/lib/doctor-report-pdf/header-profile-section.ts b/src/lib/doctor-report-pdf/header-profile-section.ts
index 27975a81b..f4a3ca0d4 100644
--- a/src/lib/doctor-report-pdf/header-profile-section.ts
+++ b/src/lib/doctor-report-pdf/header-profile-section.ts
@@ -62,12 +62,9 @@ export function buildHeaderProfileSection(
   doc.setFontSize(9);
   doc.setTextColor(80, 80, 80);
   const patientInfo: string[] = [];
-  // v1.7.0 — prefer the legal full name on the cover; fall back to the
-  // username when no full name is set (collapses exactly like the
-  // practice name when neither is present).
-  const patientName = data.patient.fullName ?? data.patient.username ?? null;
-  if (patientName) {
-    patientInfo.push(`${t("doctorReport.patient")}: ${patientName}`);
+  // Collapses like the practice name when the record has no name to print.
+  if (data.patient.name) {
+    patientInfo.push(`${t("doctorReport.patient")}: ${data.patient.name}`);
   }
   if (data.patient.dateOfBirth) {
     patientInfo.push(
diff --git a/src/lib/doctor-report-types.ts b/src/lib/doctor-report-types.ts
index b82c4fffe..2b7a73697 100644
--- a/src/lib/doctor-report-types.ts
+++ b/src/lib/doctor-report-types.ts
@@ -80,17 +80,19 @@ export interface DoctorReportData {
    */
   period: { days: number; since: string; start: string; end: string };
   patient: {
-    username: string | null;
+    /**
+     * The name the cover, the PDF metadata, the FHIR Patient and the share
+     * page print, resolved once by `patientName()`: full name, display name,
+     * login, never a managed record's generated handle. Null prints no line.
+     */
+    name: string | null;
     dateOfBirth: string | null;
     gender: string | null;
     heightCm: number | null;
-    // v1.7.0 — optional patient-identity fields for the export cover +
-    // FHIR Patient. `fullName` + `insurerName` are plaintext columns; the
-    // KVNR is NOT carried here (it's encrypted at rest and decrypted by
-    // the route, then handed to the builders separately). Optional in the
-    // type so pre-v1.7.0 fixtures that omit them still typecheck — the
-    // renderer treats absent and null identically.
-    fullName?: string | null;
+    // `insurerName` is a plaintext column; the KVNR is NOT carried here (it's
+    // encrypted at rest and decrypted by the route, then handed to the
+    // builders separately). Optional so fixtures that omit it still
+    // typecheck; the renderer treats absent and null identically.
     insurerName?: string | null;
     // v1.8.6 — German insurer institution number (IKNR), plaintext. Carried
     // here for the FHIR `Coverage` payor Organization identifier. Optional
diff --git a/src/lib/doctor-report/__tests__/leaf-gating-sweep.test.ts b/src/lib/doctor-report/__tests__/leaf-gating-sweep.test.ts
index da880ef5d..6650e83a6 100644
--- a/src/lib/doctor-report/__tests__/leaf-gating-sweep.test.ts
+++ b/src/lib/doctor-report/__tests__/leaf-gating-sweep.test.ts
@@ -130,6 +130,8 @@ function seed() {
   rows.userUnique = [
     {
       username: "owner",
+      displayName: null,
+      managedProfileAt: null,
       dateOfBirth: new Date("1980-05-05T00:00:00.000Z"),
       gender: "OTHER",
       heightCm: 180,
@@ -328,7 +330,7 @@ describe("per-leaf gating sweep", () => {
       0,
     );
     expect(Object.keys(allPayload.compliance).length).toBeGreaterThan(0);
-    expect(allPayload.patient.username).toBe("owner");
+    expect(allPayload.patient.name).toBe("Owner Name");
     expect(allPayload.patient.insurerName).toBe("Sample Insurer");
     expect(allPayload.bmi).not.toBeNull();
     expect(Object.keys(allPayload.glucoseStats).length).toBeGreaterThan(0);
@@ -457,6 +459,47 @@ describe("the derived figures ride their own leaf", () => {
   });
 });
 
+describe("the name the report prints", () => {
+  const identity = selectionFromLeaves(["PATIENT_IDENTITY"]);
+  const asUser = (fields: Record<string, unknown>) => {
+    rows.userUnique = [{ ...(rows.userUnique[0] as object), ...fields }];
+  };
+
+  it("names a managed record by its display name, never its generated login", async () => {
+    asUser({
+      username: "managed-3f9a0c1d2e3f4a5b6c7d8e9f0a1b2c3d4e5f",
+      displayName: "Robin",
+      fullName: null,
+      managedProfileAt: new Date("2026-01-01T00:00:00.000Z"),
+    });
+    const payload = await collectDoctorReportData("u1", RANGE, identity, {
+      moduleMap: moduleMap(),
+    });
+    expect(payload.patient.name).toBe("Robin");
+  });
+
+  it("prints no name for a managed record that has none", async () => {
+    asUser({
+      username: "managed-3f9a0c1d2e3f4a5b6c7d8e9f0a1b2c3d4e5f",
+      displayName: null,
+      fullName: null,
+      managedProfileAt: new Date("2026-01-01T00:00:00.000Z"),
+    });
+    const payload = await collectDoctorReportData("u1", RANGE, identity, {
+      moduleMap: moduleMap(),
+    });
+    expect(payload.patient.name).toBeNull();
+  });
+
+  it("prefers the display name over the login on an own account", async () => {
+    asUser({ username: "owner", displayName: "Jane Doe", fullName: null });
+    const payload = await collectDoctorReportData("u1", RANGE, identity, {
+      moduleMap: moduleMap(),
+    });
+    expect(payload.patient.name).toBe("Jane Doe");
+  });
+});
+
 describe("fail-closed exclusion", () => {
   it("excludes a measurement type the catalogue does not know", () => {
     const gate = resolveReportGate(
@@ -571,7 +614,7 @@ describe("the empty selection serves nothing", () => {
       selectionFromLeaves([]),
       { moduleMap: moduleMap() },
     );
-    expect(payload.patient.username).toBeNull();
+    expect(payload.patient.name).toBeNull();
     expect(payload.patient.insurerName).toBeNull();
     expect(payload.labResults).toBeNull();
     expect(payload.allergies).toBeNull();
diff --git a/src/lib/doctor-report/collect.ts b/src/lib/doctor-report/collect.ts
index e40039f56..5d76aafd3 100644
--- a/src/lib/doctor-report/collect.ts
+++ b/src/lib/doctor-report/collect.ts
@@ -84,6 +84,7 @@ import {
   loadLabResults,
 } from "./clinical-records";
 import { dayKeyAsUtcMidnight } from "@/lib/tz/date-only";
+import { patientName } from "@/lib/account-name";
 import { readingsMean } from "@/lib/measurements/day-mean";
 import { loadScreenerUnvalidatedTranslations } from "./screener-translations";
 
@@ -179,6 +180,8 @@ export async function collectDoctorReportData(
     where: { id: userId },
     select: {
       username: true,
+      displayName: true,
+      managedProfileAt: true,
       dateOfBirth: true,
       gender: true,
       heightCm: true,
@@ -720,14 +723,13 @@ export async function collectDoctorReportData(
       end: end.toISOString(),
     },
     patient: {
-      username: identityOn ? (userProfile?.username ?? null) : null,
+      name: identityOn && userProfile ? patientName(userProfile) : null,
       dateOfBirth:
         identityOn && userProfile?.dateOfBirth
           ? userProfile.dateOfBirth.toISOString()
           : null,
       gender: identityOn ? (userProfile?.gender ?? null) : null,
       heightCm: identityOn ? (userProfile?.heightCm ?? null) : null,
-      fullName: identityOn ? (userProfile?.fullName ?? null) : null,
       insurerName: insuranceOn ? (userProfile?.insurerName ?? null) : null,
       insurerIkNumber: insuranceOn
         ? (userProfile?.insurerIkNumber ?? null)
diff --git a/src/lib/fhir/__tests__/build-bundle.test.ts b/src/lib/fhir/__tests__/build-bundle.test.ts
index 473758eae..0bdc2e550 100644
--- a/src/lib/fhir/__tests__/build-bundle.test.ts
+++ b/src/lib/fhir/__tests__/build-bundle.test.ts
@@ -69,11 +69,10 @@ function makeData(overrides?: Partial<DoctorReportData>): DoctorReportData {
       end: "2026-05-03T12:00:00.000Z",
     },
     patient: {
-      username: "sample-user",
+      name: "Sample Patient",
       dateOfBirth: "1985-06-15T00:00:00.000Z",
       gender: "MALE",
       heightCm: 182,
-      fullName: "Sample Patient",
       insurerName: "Example Insurer",
     },
     practiceName: null,
@@ -181,11 +180,10 @@ describe("buildFhirDocumentBundle", () => {
     const bundle = buildFhirDocumentBundle(
       makeData({
         patient: {
-          username: "sample-user",
+          name: "Sample Patient",
           dateOfBirth: "1985-06-15T00:00:00.000Z",
           gender: "MALE",
           heightCm: 182,
-          fullName: "Sample Patient",
           insurerName: "Example Insurer",
           insurerIkNumber: "101234567",
         },
@@ -215,11 +213,10 @@ describe("buildFhirDocumentBundle", () => {
     const bundle = buildFhirDocumentBundle(
       makeData({
         patient: {
-          username: "sample-user",
+          name: "Sample Patient",
           dateOfBirth: null,
           gender: null,
           heightCm: null,
-          fullName: "Sample Patient",
           insurerName: "Example Insurer",
           insurerIkNumber: "101234567",
         },
@@ -238,11 +235,10 @@ describe("buildFhirDocumentBundle", () => {
     const bundle = buildFhirDocumentBundle(
       makeData({
         patient: {
-          username: "sample-user",
+          name: "Sample Patient",
           dateOfBirth: null,
           gender: null,
           heightCm: null,
-          fullName: "Sample Patient",
           insurerName: "Example Insurer",
           // no insurerIkNumber
         },
@@ -262,11 +258,10 @@ describe("buildFhirDocumentBundle", () => {
     const bundle = buildFhirDocumentBundle(
       makeData({
         patient: {
-          username: "sample-user",
+          name: "Sample Patient",
           dateOfBirth: null,
           gender: null,
           heightCm: null,
-          fullName: "Sample Patient",
           insurerName: "Example Insurer",
           insurerIkNumber: "101234567",
         },
@@ -284,11 +279,10 @@ describe("buildFhirDocumentBundle", () => {
     const bundle = buildFhirDocumentBundle(
       makeData({
         patient: {
-          username: "sample-user",
+          name: "Sample Patient",
           dateOfBirth: null,
           gender: null,
           heightCm: null,
-          fullName: "Sample Patient",
           // neither insurerName nor insurerIkNumber
         },
       }),
@@ -303,11 +297,10 @@ describe("buildFhirDocumentBundle", () => {
     const bundle = buildFhirDocumentBundle(
       makeData({
         patient: {
-          username: "sample-user",
+          name: "Sample Patient",
           dateOfBirth: null,
           gender: null,
           heightCm: null,
-          fullName: "Sample Patient",
           // neither insurerName nor insurerIkNumber — just a bare KVNR.
         },
       }),
diff --git a/src/lib/fhir/__tests__/conformance.test.ts b/src/lib/fhir/__tests__/conformance.test.ts
index 693da6fdf..6e924c033 100644
--- a/src/lib/fhir/__tests__/conformance.test.ts
+++ b/src/lib/fhir/__tests__/conformance.test.ts
@@ -36,11 +36,10 @@ function makeData(overrides?: Partial<DoctorReportData>): DoctorReportData {
       end: "2026-05-03T12:00:00.000Z",
     },
     patient: {
-      username: "sample-user",
+      name: "Sample Patient",
       dateOfBirth: "1985-06-15T00:00:00.000Z",
       gender: "MALE",
       heightCm: 182,
-      fullName: "Sample Patient",
       insurerName: "Example Insurer",
       insurerIkNumber: "101234567",
     },
@@ -286,7 +285,7 @@ describe("document Bundle — identity and resolvability", () => {
       fullBundle(),
       fullBundle({
         patient: {
-          username: "u",
+          name: "u",
           dateOfBirth: null,
           gender: null,
           heightCm: null,
@@ -375,7 +374,7 @@ describe("Patient.gender", () => {
     for (const [stored, expected] of cases) {
       const bundle = fullBundle({
         patient: {
-          username: "u",
+          name: "u",
           dateOfBirth: null,
           gender: stored,
           heightCm: null,
diff --git a/src/lib/fhir/__tests__/cycle-observations.test.ts b/src/lib/fhir/__tests__/cycle-observations.test.ts
index 330a83d63..0bed3d981 100644
--- a/src/lib/fhir/__tests__/cycle-observations.test.ts
+++ b/src/lib/fhir/__tests__/cycle-observations.test.ts
@@ -15,7 +15,7 @@ function baseData(overrides?: Partial<DoctorReportData>): DoctorReportData {
       end: "2026-05-03T12:00:00.000Z",
     },
     patient: {
-      username: "sample-user",
+      name: "sample-user",
       dateOfBirth: "1990-06-15T00:00:00.000Z",
       gender: "FEMALE",
       heightCm: 168,
diff --git a/src/lib/fhir/__tests__/glucose-clinical-observations.test.ts b/src/lib/fhir/__tests__/glucose-clinical-observations.test.ts
index 8562be554..c773239fc 100644
--- a/src/lib/fhir/__tests__/glucose-clinical-observations.test.ts
+++ b/src/lib/fhir/__tests__/glucose-clinical-observations.test.ts
@@ -22,7 +22,7 @@ function makeData(overrides?: Partial<DoctorReportData>): DoctorReportData {
       end: "2026-05-03T12:00:00.000Z",
     },
     patient: {
-      username: "sample-user",
+      name: "sample-user",
       dateOfBirth: "1985-06-15T00:00:00.000Z",
       gender: "MALE",
       heightCm: 182,
diff --git a/src/lib/fhir/__tests__/illness-snomed.test.ts b/src/lib/fhir/__tests__/illness-snomed.test.ts
index ce4b162c7..3377b24c8 100644
--- a/src/lib/fhir/__tests__/illness-snomed.test.ts
+++ b/src/lib/fhir/__tests__/illness-snomed.test.ts
@@ -18,7 +18,7 @@ function makeData(overrides?: Partial<DoctorReportData>): DoctorReportData {
       end: "2026-05-03T12:00:00.000Z",
     },
     patient: {
-      username: "sample-user",
+      name: "sample-user",
       dateOfBirth: "1985-06-15T00:00:00.000Z",
       gender: "MALE",
       heightCm: 182,
diff --git a/src/lib/fhir/__tests__/lab-observations.test.ts b/src/lib/fhir/__tests__/lab-observations.test.ts
index 3cb005613..02ff11d73 100644
--- a/src/lib/fhir/__tests__/lab-observations.test.ts
+++ b/src/lib/fhir/__tests__/lab-observations.test.ts
@@ -17,7 +17,7 @@ function makeData(overrides?: Partial<DoctorReportData>): DoctorReportData {
       end: "2026-05-03T12:00:00.000Z",
     },
     patient: {
-      username: "sample-user",
+      name: "sample-user",
       dateOfBirth: "1985-06-15T00:00:00.000Z",
       gender: "MALE",
       heightCm: 182,
diff --git a/src/lib/fhir/__tests__/terminology-displays.test.ts b/src/lib/fhir/__tests__/terminology-displays.test.ts
index 70ede4b70..a4c766e85 100644
--- a/src/lib/fhir/__tests__/terminology-displays.test.ts
+++ b/src/lib/fhir/__tests__/terminology-displays.test.ts
@@ -22,7 +22,7 @@ function codings(overrides: Partial<DoctorReportData>): FhirCoding[] {
       start: "2026-02-02T00:00:00.000Z",
       end: "2026-05-03T12:00:00.000Z",
     },
-    patient: { username: "sample-user", dateOfBirth: null, gender: null },
+    patient: { name: "sample-user", dateOfBirth: null, gender: null },
     practiceName: null,
     measurements: {},
     stats: {},
@@ -118,7 +118,7 @@ describe("medication codings", () => {
           start: "2026-02-02T00:00:00.000Z",
           end: "2026-05-03T12:00:00.000Z",
         },
-        patient: { username: "sample-user", dateOfBirth: null, gender: null },
+        patient: { name: "sample-user", dateOfBirth: null, gender: null },
         practiceName: null,
         measurements: {},
         stats: {},
diff --git a/src/lib/fhir/build-bundle.ts b/src/lib/fhir/build-bundle.ts
index db9225600..0f2ddf71b 100644
--- a/src/lib/fhir/build-bundle.ts
+++ b/src/lib/fhir/build-bundle.ts
@@ -315,7 +315,7 @@ export function buildFhirDocumentBundle(
   // v1.9.0 — when the aggregator capped the administration set, disclose
   // it in the narrative so the export is honest: it carries the
   // most-recent N of M acted intakes, the oldest having been omitted.
-  const displayName = data.patient.fullName ?? data.patient.username ?? null;
+  const displayName = data.patient.name;
   const truncation = data.medicationAdministrationsTruncation;
   const narrativeText = [
     `Health record for ${escapeXml(displayName ?? "patient")}.`,
diff --git a/src/lib/fhir/resources/patient.ts b/src/lib/fhir/resources/patient.ts
index 47f14bc93..dfca26ac4 100644
--- a/src/lib/fhir/resources/patient.ts
+++ b/src/lib/fhir/resources/patient.ts
@@ -49,8 +49,7 @@ export function patientResource(
     resourceType: "Patient",
     id: PATIENT_RESOURCE_ID,
   };
-  const displayName = data.patient.fullName ?? data.patient.username ?? null;
-  if (displayName) patient.name = [{ text: displayName }];
+  if (data.patient.name) patient.name = [{ text: data.patient.name }];
   const gender = administrativeGender(data.patient.gender);
   if (gender) patient.gender = gender;
   if (data.patient.dateOfBirth) {
diff --git a/src/lib/mcp/__tests__/doctor-report-module-gate.test.ts b/src/lib/mcp/__tests__/doctor-report-module-gate.test.ts
index c85a7f8a7..db607e77d 100644
--- a/src/lib/mcp/__tests__/doctor-report-module-gate.test.ts
+++ b/src/lib/mcp/__tests__/doctor-report-module-gate.test.ts
@@ -74,7 +74,7 @@ const REPORT_FIXTURE = {
     start: "2026-03-29T00:00:00.000Z",
     end: "2026-06-27T00:00:00.000Z",
   },
-  patient: { username: "tester" },
+  patient: { name: "tester" },
   stats: { WEIGHT: { avg: 80, min: 79, max: 82, count: 30, latest: 80 } },
   compliance: {},
   medications: [],
diff --git a/src/lib/mcp/__tests__/doctor-visit-summary.test.ts b/src/lib/mcp/__tests__/doctor-visit-summary.test.ts
index 01e81b3b4..5b82a4b5c 100644
--- a/src/lib/mcp/__tests__/doctor-visit-summary.test.ts
+++ b/src/lib/mcp/__tests__/doctor-visit-summary.test.ts
@@ -29,7 +29,7 @@ function payload(overrides: Partial<DoctorReportData> = {}): DoctorReportData {
       end: "2026-04-01T00:00:00.000Z",
     },
     patient: {
-      username: null,
+      name: null,
       dateOfBirth: null,
       gender: null,
       heightCm: null,
diff --git a/src/lib/mcp/__tests__/prompts.test.ts b/src/lib/mcp/__tests__/prompts.test.ts
index d321aa8e9..ffd37d7ad 100644
--- a/src/lib/mcp/__tests__/prompts.test.ts
+++ b/src/lib/mcp/__tests__/prompts.test.ts
@@ -73,8 +73,7 @@ function reportFixture(
       end: "2026-06-27T00:00:00.000Z",
     },
     patient: {
-      username: "tester",
-      fullName: "A Person",
+      name: "A Person",
       dateOfBirth: "1990-01-01",
       gender: "female",
       heightCm: 170,
@@ -213,8 +212,7 @@ describe("doctor_visit_summary — grounding + structure", () => {
         .text,
     );
     const patient = data.patient as Record<string, unknown>;
-    expect(patient).not.toHaveProperty("fullName");
-    expect(patient).not.toHaveProperty("username");
+    expect(patient).not.toHaveProperty("name");
     expect(patient.dateOfBirth).toBe("1990-01-01");
   });
 });
diff --git a/src/lib/mcp/__tests__/resources.test.ts b/src/lib/mcp/__tests__/resources.test.ts
index c402eaf6f..945023533 100644
--- a/src/lib/mcp/__tests__/resources.test.ts
+++ b/src/lib/mcp/__tests__/resources.test.ts
@@ -224,8 +224,7 @@ describe("healthlog://report/doctor-visit", () => {
         end: "2026-06-27T00:00:00.000Z",
       },
       patient: {
-        username: "tester",
-        fullName: "A Person",
+        name: "A Person",
         dateOfBirth: "1990-01-01",
         gender: "female",
         heightCm: 170,
@@ -267,8 +266,7 @@ describe("healthlog://report/doctor-visit", () => {
     expect(result).toHaveProperty("illnessEpisodes");
     // Patient name never leaks.
     const patient = result.patient as Record<string, unknown>;
-    expect(patient).not.toHaveProperty("fullName");
-    expect(patient).not.toHaveProperty("username");
+    expect(patient).not.toHaveProperty("name");
   });
 
   it("omits absent sections honestly (no zero-fill)", async () => {
diff --git a/tests/integration/doctor-report-sections.test.ts b/tests/integration/doctor-report-sections.test.ts
index 8b857cf4d..759dd957a 100644
--- a/tests/integration/doctor-report-sections.test.ts
+++ b/tests/integration/doctor-report-sections.test.ts
@@ -314,7 +314,7 @@ describe("doctor-report — per-section toggles", () => {
     expect(data.labResults).toBeNull();
     expect(data.allergies).toBeNull();
     expect(data.familyHistory).toBeNull();
-    expect(data.patient.username).toBeNull();
+    expect(data.patient.name).toBeNull();
     expect(data.patient.insurerName).toBeNull();
   });
 });