If honorary staff status members don't hold an active medical license, do they need to be enrolled in the NPDB?

If they’re a member of your medical staff, and you allow people without a license to be on your medical staff, then you need query the NPDB. It’s not a function of whether they’re licensed or not, it’s a function of whether they have been made a member of your medical staff or your healthcare organization.

One suggestion is to create a “professional staff.” It’s not the official organized medical staff; it is for the community of practitioners that want to relate to your institution. They don’t need formal membership or privileges but your organization wants them to feel part of your medical community. There are no obligations, but it entitles people to get information, get newsletters, updates about the hospital; they can come to continuing medical education if they want and participate in [public events from time to time]. It’s a way to connect with a group of practitioners retired or just loosely connected to the hospital, without putting them on the organized medical staff.

But if you put them on the medical staff, the Data Bank requires you to make the query.

Source: FPPE and the Revised NPDB Guidebook: How to Address New Reporting Challenges