diff --git a/packages/gittensory-mcp/README.md b/packages/gittensory-mcp/README.md
index 6a9cc284..ed48a82b 100644
--- a/packages/gittensory-mcp/README.md
+++ b/packages/gittensory-mcp/README.md
@@ -35,6 +35,7 @@ gittensory-mcp whoami
 gittensory-mcp status
 gittensory-mcp changelog
 gittensory-mcp doctor
+gittensory-mcp doctor --exit-code
 gittensory-mcp profile list
 gittensory-mcp profile create work
 gittensory-mcp profile switch work
@@ -123,6 +124,8 @@ gittensory-mcp logout --profile work
 
 Use `--profile <name>` on `login`, `logout`, `whoami`, `status`, and `doctor`, or set `GITTENSORY_PROFILE`. `logout` only clears the selected local profile unless `--all` is passed. Profile output redacts session tokens and local config paths.
 
+By default `gittensory-mcp doctor` always exits 0. Pass `--exit-code` to make it exit non-zero when a diagnostic check fails (`status: "needs_attention"`), so it can gate a CI step or pre-commit hook. Warnings still exit 0.
+
 ## Base-Agent Mode
 
 The agent commands are copilot-only. They rank, explain, preflight, and draft public-safe packets, but they do not edit code, open PRs, post comments, close, merge, or label from the local wrapper.
diff --git a/packages/gittensory-mcp/bin/gittensory-mcp.js b/packages/gittensory-mcp/bin/gittensory-mcp.js
index ef027aff..51c6aa3e 100755
--- a/packages/gittensory-mcp/bin/gittensory-mcp.js
+++ b/packages/gittensory-mcp/bin/gittensory-mcp.js
@@ -185,8 +185,8 @@ const agentRunIdShape = {
 };
 
 if (cliArgs[0] && cliArgs[0] !== "--stdio") {
-  await runCli(cliArgs);
-  process.exit(0);
+  const exitCode = await runCli(cliArgs);
+  process.exit(typeof exitCode === "number" ? exitCode : 0);
 }
 
 const server = new McpServer({
@@ -1394,7 +1394,7 @@ function printHelp() {
   gittensory-mcp status [--profile name] [--json]
   gittensory-mcp profile list|create|switch|remove [name] [--json]
   gittensory-mcp changelog [--json]
-  gittensory-mcp doctor [--profile name] [--cwd path] [--json]
+  gittensory-mcp doctor [--profile name] [--cwd path] [--exit-code] [--json]
   gittensory-mcp cache status|clear [--json]
   gittensory-mcp init-client --print codex|claude|cursor|mcp [--json]
   gittensory-mcp decision-pack --login <github-login> [--json]
@@ -1820,6 +1820,9 @@ async function doctor(options) {
       }
     }
   }
+  // Opt-in: let `doctor` gate CI/pre-commit by exiting non-zero when a check fails. The default
+  // stays exit 0 so existing scripts that ignore the exit code keep working.
+  return options.exitCode && payload.status === "needs_attention" ? 1 : 0;
 }
 
 function doctorStatus(checks) {
diff --git a/test/unit/mcp-cli.test.ts b/test/unit/mcp-cli.test.ts
index c214fe86..ba47adbb 100644
--- a/test/unit/mcp-cli.test.ts
+++ b/test/unit/mcp-cli.test.ts
@@ -1064,6 +1064,63 @@ describe("gittensory-mcp CLI", () => {
     expect(() => run(["completion"])).toThrow(/Usage: gittensory-mcp completion <bash\|zsh\|fish>/);
     expect(() => run(["completion", "powershell"])).toThrow(/Unsupported shell: powershell/);
   });
+
+  it("keeps doctor exit code 0 by default even when a check fails", async () => {
+    tempDir = mkdtempSync(join(tmpdir(), "gittensory-cli-"));
+    const url = await startFixtureServer();
+    // No token configured -> the auth check fails -> status "needs_attention".
+    const payload = JSON.parse(
+      await runAsync(["doctor", "--json"], {
+        GITTENSORY_API_URL: url,
+        GITTENSORY_CONFIG_DIR: tempDir,
+        GITTENSORY_SKIP_NPM_VERSION_CHECK: "true",
+      }),
+    ) as { status: string; checks: Array<{ name: string; status: string }> };
+    expect(payload.status).toBe("needs_attention");
+    expect(payload.checks).toEqual(expect.arrayContaining([expect.objectContaining({ name: "auth", status: "fail" })]));
+  });
+
+  it("exits non-zero from doctor --exit-code when a check fails", async () => {
+    tempDir = mkdtempSync(join(tmpdir(), "gittensory-cli-"));
+    const url = await startFixtureServer();
+    let exitCode = 0;
+    let stdout = "";
+    try {
+      stdout = execFileSync("node", [bin, "doctor", "--exit-code", "--json"], {
+        encoding: "utf8",
+        env: {
+          ...process.env,
+          GITTENSORY_API_TIMEOUT_MS: "1000",
+          GITTENSORY_API_URL: url,
+          GITTENSORY_CONFIG_DIR: tempDir,
+          GITTENSORY_SKIP_NPM_VERSION_CHECK: "true",
+        },
+        stdio: ["ignore", "pipe", "pipe"],
+      });
+    } catch (error) {
+      const execError = error as { status?: number | null; stdout?: string };
+      exitCode = execError.status ?? 0;
+      stdout = execError.stdout ?? "";
+    }
+    expect(exitCode).toBe(1);
+    // The diagnostic report is still printed; only the process exit code changes.
+    expect((JSON.parse(stdout) as { status: string }).status).toBe("needs_attention");
+  });
+
+  it("keeps doctor --exit-code at 0 when checks pass", async () => {
+    tempDir = mkdtempSync(join(tmpdir(), "gittensory-cli-"));
+    const url = await startFixtureServer();
+    // runAsync resolves only on a zero exit code, so reaching the assertion proves exit 0.
+    const payload = JSON.parse(
+      await runAsync(["doctor", "--exit-code", "--json"], {
+        GITTENSORY_API_URL: url,
+        GITTENSORY_TOKEN: "session-token",
+        GITTENSORY_CONFIG_DIR: tempDir,
+        GITTENSORY_SKIP_NPM_VERSION_CHECK: "true",
+      }),
+    ) as { status: string };
+    expect(payload.status).toMatch(/ok|warnings/);
+  });
 });
 
 function run(args: string[], env: Record<string, string> = {}) {