Whanganui District Health Board chief executive Julie Patterson is stepping down in October.
Mrs Patterson has held the position since 2008, after first being associated with Whanganui Hospital about 50 years ago when she did her nurse training there.
The board chair, Dot McKinnon, said Mrs Patterson's achievements included bringing the DHB in on budget last financial year, after inheriting a $10 million deficit when she took over nine years ago.
Her achievements also included transforming its struggling metal health service to one that was now held up as an example of best practice.
In recent months, Mrs Patterson was the spokesperson for the country's 20 DHBs during the dispute with junior doctors over working conditions.
