Top-Rated Nonprofits in North Carolina 2026
North Carolina has 23 nonprofits with $27.6B in combined revenue. The top-rated organization is Duke University Health System Inc with an Efficiency Score of 86/100.
North Carolina has 23 nonprofits in the IRS Form 990 dataset ranked here by efficiency score. The LakeQuality nonprofit efficiency rubric combines program-spending ratio (50%), revenue growth consistency (20%), fund reserves (20%), and CEO compensation ratio (10%) into a 0-100 composite.
Reading the ranking: top of the list typically combines strong program-spending discipline (the highest-weighted factor) with stable multi-year revenue and reasonable executive compensation. Large hospital and university systems often appear near the top in any state — their scale lets them keep program ratios high while still investing in infrastructure. Each nonprofit links to its full Form 990 profile. For donors trying to choose between organizations, the efficiency grade is a useful triage — but the underlying program-spending ratio, the multi-year revenue trend, and the comp ratio matter more than the composite letter on any individual decision.
Top 20 of 23 Nonprofits in North Carolina
| # | Organization | Category | Revenue | CEO Pay | Score |
|---|---|---|---|---|---|
| 1 | Duke University Health System Inc | Health | $4.7B | $0 | A (86) |
| 2 | Wingate University | Education | $167.7M | $0 | A (86) |
| 3 | Pitt County Memorial Hospital Inc | Health | $1.8B | $0 | A (84) |
| 4 | Wakemed | Health | $2.1B | $0 | A (83) |
| 5 | Novant Health Inc | Health | $4.0B | $0 | A (81) |
| 6 | Presbyterian Hospital | Health | $2.0B | $0 | A (80) |
| 7 | North Carolina Baptist Hospital | Health | $3.0B | $0 | B (77) |
| 8 | Wake Forest University Health Sciences | Education | $1.2B | $0 | B (77) |
| 9 | Elon University | Education | $389.1M | $0 | B (77) |
| 10 | North Carolina Performing Arts Center At Charlotte Foundation | Arts, Culture & Humanities | $45.7M | $0 | B (77) |
| 11 | Educational Testing Service | Education | $1.1B | $0 | B (76) |
| 12 | High Point University | Education | $422.1M | $0 | B (76) |
| 13 | Serc Reliability Corporation | Environment & Animals | $33.2M | $0 | B (76) |
| 14 | Campbell University | Education | $229.2M | $0 | B (73) |
| 15 | Duke University | Education | $3.7B | $0 | B (68) |
| 16 | Wake Forest University | Education | $686.9M | $0 | B (68) |
| 17 | North Carolina State University Foundation Inc | Education | $64.3M | $0 | B (68) |
| 18 | Triangle Land Conservancy Inc | Environment & Animals | $18.2M | $0 | B (68) |
| 19 | Ncinnovation Inc | Education | $10.3M | $0 | B (67) |
| 20 | Davidson College | Education | $202.4M | $0 | C (63) |
Nonprofit financial data for North Carolina is sourced from IRS Form 990 filings, which all tax-exempt organizations must file annually.
Frequently Asked Questions
Duke University Health System Inc is the top-rated nonprofit in North Carolina with an Efficiency Score of 86/100 (Grade A) and $4.7B in annual revenue.
North Carolina has 23 nonprofits in our database with a combined $27.6B in total revenue.
The Efficiency Score (0-100, A-F) measures nonprofit effectiveness based on program expense ratio (50%), revenue growth consistency (20%), fund reserves (20%), and CEO compensation ratio (10%). Higher scores indicate more efficient organizations.
Efficiency Score: program expense ratio (50%), revenue growth consistency (20%), fund reserves (20%), CEO compensation ratio (10%).