Co-Founder & CEO · Alara Imaging
Nate
Mazonson
He keeps picking the industries everyone else gave up on. First food. Now the wiring beneath every CT scan.
Building the gateway between hospitals and the cloud
He keeps picking the industries everyone else gave up on. First food. Now the wiring beneath every CT scan.
Aradiologist, a radiation-safety researcher, and a vertical-farming founder walk into a startup. The founder is the one who isn't a doctor, and he's running the place. That is the strange arithmetic of Alara Imaging, and Nate Mazonson is the answer.
Walk into the basement of almost any hospital and you will find a technology stack that predates the smartphone. Medical images move on protocols older than most of the engineers asked to maintain them. Getting a CT scan from a scanner to a cloud where an algorithm can read it can mean a six-month security audit and a tangle of one-off integrations.
Alara builds the box that sits in that basement. The company calls it a gateway-as-a-service - a local node that ingests, normalizes, secures, and ships medical images in both directions between a health system and the cloud. HIPAA-compliant. SOC II-compliant. Built so a health-tech company can plug in without re-litigating the hospital's security review every single time.
It is not glamorous. It is the kind of infrastructure that, when it works, becomes invisible. That is exactly the kind of problem Mazonson keeps choosing.
“Alara's Gateway overcomes a significant barrier to medical imaging innovation by ushering in a modern, machine learning-enabled framework to an antiquated technology stack.”
Nate Mazonson, on the NVIDIA collaboration, November 2023The partners have lined up behind that thesis. In 2022 Alara launched its gateway as an AWS Partner, wired straight into Amazon HealthLake Imaging. A year later it announced a collaboration with NVIDIA, integrating with Project MONAI - the open framework for building and deploying medical AI in clinical settings. The pitch in both cases was the same: the images already exist; the bottleneck is moving them safely. Fix the pipe and the AI follows.
The name is the thesisRadiologists know the acronym before they know much else: ALARA, “As Low As Reasonably Achievable,” the governing principle for keeping radiation doses safe. The company borrowed it on purpose. Alara serves as a measure steward for new radiology-focused clinical quality measures inside CMS quality payment programs - the software that helps hospitals prove their imaging is as safe as it should be.
That bent toward safety came in part from the co-founders. Mazonson built Alara in 2019 with two UCSF physicians: Marc Kohli, the medical director of imaging informatics at UCSF Health, and Rebecca Smith-Bindman, whose research documented just how wildly radiation doses vary from one CT scan to the next. The doctors brought the clinical conviction. Mazonson brought the operating playbook.
Rewind. Mazonson studied environmental science and engineering at Dartmouth, focused on climate change, and graduated with honors in 2009. The trigger he points to is almost a cliché of the era - Al Gore's An Inconvenient Truth - except he actually rearranged his life around it. His takeaway was blunt.
“We are not on a sustainable trajectory as a species.”
Nate Mazonson, on what pushed him into cleantechSo he went looking for the companies that might bend that trajectory. For five years he sat on the investing side - Associate Investment Director at Cambridge Associates, where he advised endowment portfolios worth a combined $3.5 billion, then a stint in venture capital at Kleiner Perkins. He hunted for genuinely transformational businesses in water, food, and energy. He kept not finding enough of them.
Most people make peace with that. Mazonson went to Stanford's Graduate School of Business to get the operating skills his engineering degree never gave him, and in 2015 he co-founded one himself: Plenty, the vertical-farming company, alongside Matt Barnard and Nate Storey. The product was, literally, towers of kale grown outside cities - fresh greens harvested and shelved within hours instead of trucked across a continent.
Food and medical imaging look like opposite worlds. They are not. Both are old, regulated, physical industries running on infrastructure built for a slower era. Both punish anyone who tries to modernize them halfway. Mazonson's career is the same move, run twice.
The patternThe reflex from his investing years stuck: stop waiting for the transformational company to show up, and build it. He found the most antiquated technology stack he could - then dragged it toward the present. In 2025 the company kept staffing up for that fight, adding senior medical-imaging operators to the executive team.
“...ushering in a cloud-native, modern framework to an antiquated technology stack.”
Nate Mazonson, on the AWS launch, November 2022There is a quiet ambition under all of it. If the gateway becomes the default way health systems hand their images to the cloud, then every downstream improvement - faster reads, safer doses, better AI - rides on a pipe Mazonson's team built. Invisible infrastructure is the most powerful kind. He seems to know it.