diff --git a/src/lib/jobs/__tests__/intake-auto-skip.test.ts b/src/lib/jobs/__tests__/intake-auto-skip.test.ts
new file mode 100644
index 000000000..446ff7c16
--- /dev/null
+++ b/src/lib/jobs/__tests__/intake-auto-skip.test.ts
@@ -0,0 +1,223 @@
+/**
+ * v1.4.46 — coverage for the hourly intake-auto-skip helper.
+ *
+ * The helper runs a single `updateMany` against `MedicationIntakeEvent`
+ * with the `skipped = false AND takenAt IS NULL AND scheduledFor < cutoff`
+ * gate, where `cutoff = now - 24 h`. These tests pin:
+ *   * cron + queue contract (constants don't drift),
+ *   * cutoff is `now - 24 h` exactly (off-by-one safety),
+ *   * Prisma `updateMany` is called with the spec'd shape,
+ *   * idempotency-by-construction (a second pass on the same state
+ *     finds zero candidates because the predicate has already flipped
+ *     them).
+ */
+import { describe, it, expect, vi, beforeEach } from "vitest";
+import type { PrismaClient } from "@/generated/prisma/client";
+
+import {
+  INTAKE_AUTO_SKIP_CRON,
+  INTAKE_AUTO_SKIP_GRACE_HOURS,
+  INTAKE_AUTO_SKIP_QUEUE,
+  runIntakeAutoSkipPass,
+} from "../intake-auto-skip";
+
+interface FakeIntakeRow {
+  id: string;
+  userId: string;
+  scheduledFor: Date;
+  takenAt: Date | null;
+  skipped: boolean;
+}
+
+interface FakeUpdateManyWhere {
+  skipped?: boolean;
+  takenAt?: null;
+  scheduledFor?: { lt: Date };
+}
+
+function makeFakePrisma(state: { rows: FakeIntakeRow[] }) {
+  return {
+    medicationIntakeEvent: {
+      updateMany: vi.fn(
+        async ({
+          where,
+          data,
+        }: {
+          where: FakeUpdateManyWhere;
+          data: { skipped: boolean };
+        }) => {
+          let count = 0;
+          for (const row of state.rows) {
+            if (where.skipped !== undefined && row.skipped !== where.skipped)
+              continue;
+            if (where.takenAt === null && row.takenAt !== null) continue;
+            if (
+              where.scheduledFor?.lt !== undefined &&
+              row.scheduledFor.getTime() >= where.scheduledFor.lt.getTime()
+            )
+              continue;
+            row.skipped = data.skipped;
+            count += 1;
+          }
+          return { count };
+        },
+      ),
+    },
+  } as unknown as PrismaClient;
+}
+
+const NOW = new Date("2026-05-22T12:00:00Z");
+const NOW_MS = NOW.getTime();
+const HOUR_MS = 60 * 60 * 1000;
+const DAY_MS = 24 * HOUR_MS;
+
+describe("intake-auto-skip — schedule contract", () => {
+  it("cron fires hourly at :05 to dodge the :00 reminder-check tick", () => {
+    expect(INTAKE_AUTO_SKIP_CRON).toBe("5 * * * *");
+  });
+
+  it("queue name stays stable so the scheduler entry doesn't desync", () => {
+    expect(INTAKE_AUTO_SKIP_QUEUE).toBe("intake-auto-skip");
+  });
+
+  it("grace window is exactly 24 hours", () => {
+    expect(INTAKE_AUTO_SKIP_GRACE_HOURS).toBe(24);
+  });
+});
+
+describe("runIntakeAutoSkipPass", () => {
+  beforeEach(() => {
+    vi.clearAllMocks();
+  });
+
+  it("flips pending rows older than 24 h to skipped=true", async () => {
+    const rows: FakeIntakeRow[] = [
+      // Stale + unmarked → must flip.
+      {
+        id: "i-stale-1",
+        userId: "u1",
+        scheduledFor: new Date(NOW_MS - 30 * HOUR_MS),
+        takenAt: null,
+        skipped: false,
+      },
+      // Stale + unmarked (different user) → must flip.
+      {
+        id: "i-stale-2",
+        userId: "u2",
+        scheduledFor: new Date(NOW_MS - 48 * HOUR_MS),
+        takenAt: null,
+        skipped: false,
+      },
+      // Recent (< 24 h) → must stay pending.
+      {
+        id: "i-recent",
+        userId: "u1",
+        scheduledFor: new Date(NOW_MS - 6 * HOUR_MS),
+        takenAt: null,
+        skipped: false,
+      },
+      // Already taken → must stay.
+      {
+        id: "i-taken",
+        userId: "u1",
+        scheduledFor: new Date(NOW_MS - 36 * HOUR_MS),
+        takenAt: new Date(NOW_MS - 30 * HOUR_MS),
+        skipped: false,
+      },
+      // Already manually skipped → must stay.
+      {
+        id: "i-already-skipped",
+        userId: "u1",
+        scheduledFor: new Date(NOW_MS - 48 * HOUR_MS),
+        takenAt: null,
+        skipped: true,
+      },
+    ];
+    const state = { rows };
+    const prisma = makeFakePrisma(state);
+
+    const result = await runIntakeAutoSkipPass(prisma, { nowMs: NOW_MS });
+
+    expect(result.skippedCount).toBe(2);
+    expect(result.cutoff.getTime()).toBe(NOW_MS - DAY_MS);
+    expect(state.rows.find((r) => r.id === "i-stale-1")?.skipped).toBe(true);
+    expect(state.rows.find((r) => r.id === "i-stale-2")?.skipped).toBe(true);
+    expect(state.rows.find((r) => r.id === "i-recent")?.skipped).toBe(false);
+    expect(state.rows.find((r) => r.id === "i-taken")?.skipped).toBe(false);
+    expect(
+      state.rows.find((r) => r.id === "i-already-skipped")?.skipped,
+    ).toBe(true);
+  });
+
+  it("calls prisma.updateMany with the spec'd where + data shape", async () => {
+    const state = { rows: [] as FakeIntakeRow[] };
+    const prisma = makeFakePrisma(state);
+
+    await runIntakeAutoSkipPass(prisma, { nowMs: NOW_MS });
+
+    expect(prisma.medicationIntakeEvent.updateMany).toHaveBeenCalledTimes(1);
+    expect(prisma.medicationIntakeEvent.updateMany).toHaveBeenCalledWith({
+      where: {
+        skipped: false,
+        takenAt: null,
+        scheduledFor: { lt: new Date(NOW_MS - DAY_MS) },
+      },
+      data: { skipped: true },
+    });
+  });
+
+  it("is idempotent — a second pass on the same state finds zero candidates", async () => {
+    const rows: FakeIntakeRow[] = [
+      {
+        id: "i-stale",
+        userId: "u1",
+        scheduledFor: new Date(NOW_MS - 30 * HOUR_MS),
+        takenAt: null,
+        skipped: false,
+      },
+    ];
+    const state = { rows };
+    const prisma = makeFakePrisma(state);
+
+    const first = await runIntakeAutoSkipPass(prisma, { nowMs: NOW_MS });
+    expect(first.skippedCount).toBe(1);
+
+    const second = await runIntakeAutoSkipPass(prisma, { nowMs: NOW_MS });
+    expect(second.skippedCount).toBe(0);
+  });
+
+  it("does NOT flip rows exactly at the 24 h boundary (uses strict <)", async () => {
+    // The SQL gate is `scheduledFor < NOW - 24h` — a row whose
+    // `scheduledFor` lands at the cutoff instant must stay pending so
+    // the user still has the closing minute of the window to mark it.
+    const rows: FakeIntakeRow[] = [
+      {
+        id: "i-boundary",
+        userId: "u1",
+        scheduledFor: new Date(NOW_MS - DAY_MS),
+        takenAt: null,
+        skipped: false,
+      },
+    ];
+    const state = { rows };
+    const prisma = makeFakePrisma(state);
+
+    const result = await runIntakeAutoSkipPass(prisma, { nowMs: NOW_MS });
+    expect(result.skippedCount).toBe(0);
+    expect(state.rows[0].skipped).toBe(false);
+  });
+
+  it("uses Date.now() when no nowMs override is supplied", async () => {
+    vi.useFakeTimers();
+    vi.setSystemTime(NOW);
+    try {
+      const state = { rows: [] as FakeIntakeRow[] };
+      const prisma = makeFakePrisma(state);
+
+      const result = await runIntakeAutoSkipPass(prisma);
+      expect(result.cutoff.getTime()).toBe(NOW_MS - DAY_MS);
+    } finally {
+      vi.useRealTimers();
+    }
+  });
+});
diff --git a/src/lib/jobs/intake-auto-skip.ts b/src/lib/jobs/intake-auto-skip.ts
new file mode 100644
index 000000000..acb72824b
--- /dev/null
+++ b/src/lib/jobs/intake-auto-skip.ts
@@ -0,0 +1,89 @@
+/**
+ * v1.4.46 — hourly cron that auto-skips medication intake events the
+ * user never marked. Without it the dashboard "compliance" tile keeps
+ * counting a missed dose as `pending` forever (the row's `takenAt`
+ * stays NULL and `skipped` stays false), which inflates the "missing"
+ * column on the streak chart and prevents the next day's intake from
+ * rendering cleanly in the "today" window.
+ *
+ * Rule: flip `skipped = true` for every `MedicationIntakeEvent` where:
+ *   * `skipped = false` AND
+ *   * `takenAt IS NULL` AND
+ *   * `scheduledFor < NOW() - INTERVAL '24 hours'`
+ *
+ * The 24 h grace window is intentional: a slightly late mark
+ * (user took the morning dose at noon when the schedule was 09:00)
+ * shouldn't get auto-skipped before the user has had a full day to
+ * record it. Anything older than 24 h is reliably forgotten — the
+ * compliance rollup needs a terminal state to count it as a real miss.
+ *
+ * Idempotent by construction: the second pass within the same hour
+ * finds zero candidate rows because the first pass already flipped
+ * them. Safe to re-run on worker restart.
+ *
+ * Compliance-rollup coupling: the `skipped = true` transition is the
+ * same terminal state the user's manual "Skip" button writes, so the
+ * compliance rollup recompute path triggered by the next ingest /
+ * dashboard read picks the new rows up without any extra plumbing.
+ * The helper deliberately does NOT touch the rollup directly — the
+ * next read-path call lazily folds the day, and a fresh
+ * compliance-rollup backfill (boot-time) sweeps any historical gaps.
+ */
+import type { PrismaClient } from "@/generated/prisma/client";
+
+export const INTAKE_AUTO_SKIP_QUEUE = "intake-auto-skip";
+
+/**
+ * Cron schedule. Hourly at :05 so the tick doesn't collide with the
+ * top-of-the-hour reminder-check (:00) or the moodlog-sync (:30)
+ * cadences. Europe/Berlin matches the rest of the worker's schedules.
+ */
+export const INTAKE_AUTO_SKIP_CRON = "5 * * * *";
+
+/**
+ * Grace window before auto-skip kicks in. 24 h matches the spec and
+ * the user's real-world cadence (late entries up to a full day after
+ * the schedule are still legitimate).
+ */
+export const INTAKE_AUTO_SKIP_GRACE_HOURS = 24;
+
+export interface IntakeAutoSkipPayload {
+  triggeredAt: string;
+}
+
+export interface IntakeAutoSkipResult {
+  /** Rows that flipped from pending to `skipped = true` on this pass. */
+  skippedCount: number;
+  /** Cutoff timestamp the pass applied — useful for the audit trail. */
+  cutoff: Date;
+}
+
+/**
+ * Run one auto-skip pass. Returns the flipped row count + the cutoff
+ * the pass used. Pure function over the injected Prisma client so
+ * unit tests can drive it with an in-memory fake.
+ *
+ * `nowMs` is injectable for the same testing reason — the production
+ * caller passes `Date.now()`; tests pass a frozen instant so the
+ * cutoff arithmetic is deterministic.
+ */
+export async function runIntakeAutoSkipPass(
+  prisma: PrismaClient,
+  options: { nowMs?: number } = {},
+): Promise<IntakeAutoSkipResult> {
+  const nowMs = options.nowMs ?? Date.now();
+  const cutoff = new Date(
+    nowMs - INTAKE_AUTO_SKIP_GRACE_HOURS * 60 * 60 * 1000,
+  );
+
+  const { count } = await prisma.medicationIntakeEvent.updateMany({
+    where: {
+      skipped: false,
+      takenAt: null,
+      scheduledFor: { lt: cutoff },
+    },
+    data: { skipped: true },
+  });
+
+  return { skippedCount: count, cutoff };
+}
diff --git a/src/lib/jobs/reminder-worker.ts b/src/lib/jobs/reminder-worker.ts
index 9298c94f4..9ed964804 100644
--- a/src/lib/jobs/reminder-worker.ts
+++ b/src/lib/jobs/reminder-worker.ts
@@ -50,6 +50,12 @@ import {
   MEDICATION_INVENTORY_EXPIRE_CRON,
   type MedicationInventoryExpirePayload,
 } from "@/lib/jobs/medication-inventory-expire";
+import {
+  INTAKE_AUTO_SKIP_QUEUE,
+  INTAKE_AUTO_SKIP_CRON,
+  runIntakeAutoSkipPass,
+  type IntakeAutoSkipPayload,
+} from "@/lib/jobs/intake-auto-skip";
 import {
   APPLE_HEALTH_IMPORT_QUEUE,
   APPLE_HEALTH_IMPORT_CONCURRENCY,
@@ -1391,6 +1397,35 @@ async function handleMedicationInventoryExpire(
   });
 }
 
+/**
+ * v1.4.46 — hourly auto-skip for stale unmarked medication intakes.
+ *
+ * Flips `MedicationIntakeEvent.skipped` to `true` for every event the
+ * user neither took nor explicitly skipped within the 24 h grace
+ * window. The pure helper lives in `@/lib/jobs/intake-auto-skip` so a
+ * unit test can drive it with an in-memory fake Prisma; this wrapper
+ * threads the worker's pg-boss + background-event plumbing.
+ */
+async function handleIntakeAutoSkip(jobs: Job<IntakeAutoSkipPayload>[]) {
+  void jobs;
+  await withBackgroundEvent("job.intake_auto_skip", async (evt) => {
+    const prisma = getWorkerPrisma();
+    try {
+      const result = await runIntakeAutoSkipPass(prisma, {
+        nowMs: Date.now(),
+      });
+      evt.addMeta("intake_auto_skip_count", result.skippedCount);
+      evt.addMeta("intake_auto_skip_cutoff", result.cutoff.toISOString());
+    } catch (err) {
+      evt.addWarning(
+        `intake-auto-skip failed: ${
+          err instanceof Error ? err.message : String(err)
+        }`,
+      );
+    }
+  });
+}
+
 async function handleOffhostBackup(jobs: Job<OffhostBackupPayload>[]) {
   void jobs;
   await withBackgroundEvent("job.offhost_backup", async (evt) => {
@@ -1642,6 +1677,11 @@ export async function startReminderWorker() {
     GEO_BACKFILL_QUEUE,
     PR_DETECTION_QUEUE,
     MEDICATION_INVENTORY_EXPIRE_QUEUE,
+    // v1.4.46 — hourly auto-skip pass for stale unmarked intakes.
+    // Same pg-boss v12 createQueue contract as the other crons; without
+    // this entry the schedule silently no-ops and pending rows older
+    // than 24 h pile up unflipped.
+    INTAKE_AUTO_SKIP_QUEUE,
     APPLE_HEALTH_IMPORT_QUEUE,
     ROLLUP_RECOMPUTE_QUEUE,
     ROLLUP_FULL_BACKFILL_QUEUE,
@@ -1723,6 +1763,11 @@ export async function startReminderWorker() {
     // EXPIRED at 03:30 Europe/Berlin (in the existing 02:xx–03:xx
     // maintenance window, right after idempotency-cleanup).
     [MEDICATION_INVENTORY_EXPIRE_QUEUE, MEDICATION_INVENTORY_EXPIRE_CRON],
+    // v1.4.46 — hourly auto-skip for medication intakes the user never
+    // marked. Cron `5 * * * *` slots off the top-of-the-hour
+    // reminder-check (:00) and the moodlog-sync (:30) so the three
+    // hourly ticks don't pile up on the same boss poll.
+    [INTAKE_AUTO_SKIP_QUEUE, INTAKE_AUTO_SKIP_CRON],
     // v1.4.37 W7c — nightly fold of per-sample APPLE_HEALTH cumulative
     // rows into one row per day per type. Slots between the
     // audit-log cleanup (03:15) and the feedback aggregator (04:00).
@@ -1859,6 +1904,15 @@ export async function startReminderWorker() {
     { localConcurrency: 1 },
     handleMedicationInventoryExpire,
   );
+  // v1.4.46 — hourly auto-skip for stale unmarked intakes.
+  // Single-flight: two ticks racing against the same row pile is wasted
+  // work, and the underlying `updateMany` is the canonical idempotent
+  // shape anyway.
+  await boss.work<IntakeAutoSkipPayload>(
+    INTAKE_AUTO_SKIP_QUEUE,
+    { localConcurrency: 1 },
+    handleIntakeAutoSkip,
+  );
   // v1.4.34 — Apple Health export.zip ingest worker. localConcurrency
   // caps at 1 because the parse loop is CPU-bound and a concurrent
   // second 1 GB import would race the first for RSS.