Active Directory & Privileged Access Testing

Active Directory is the backbone of identity and access in most healthcare environments. If an attacker can escalate from a standard user to domain administrator, they can potentially reach every system, every patient record, every backup, and every clinical application in the organization.

Discuss AD & Privileged Access Testing

Why it matters

Domain admin access is the key to everything

In nearly every major healthcare ransomware incident, the attacker gained domain administrator access before deploying ransomware. Active Directory misconfigurations, excessive privileges, weak password policies, and legacy trust relationships create the pathways attackers use.

What the assessment evaluates

Kerberoasting and AS-REP roasting exposure

Password policy strength and credential hygiene

Group Policy Object (GPO) misconfigurations

Excessive privileges and over-permissioned accounts

Service account security and delegation settings

Trust relationships between domains and forests

LDAP signing and channel binding configuration

AdminSDHolder and protected group membership

Certificate Services (AD CS) abuse paths

Stale accounts, disabled accounts with active credentials

What the engagement determines

Whether a standard user can escalate to domain admin

How many distinct escalation paths exist

Whether service accounts can be compromised and leveraged

Whether credential theft techniques succeed in the environment

Whether privileged access is properly tiered and segmented

Whether monitoring detects privilege escalation attempts

Whether legacy configurations create exploitable weaknesses

Healthcare relevance

Healthcare organizations often have complex AD environments with multiple locations, legacy systems, shared workstations, and vendor accounts. These environments accumulate privilege escalation paths over time. Regular AD-focused testing helps identify and close those paths before they are exploited.

Evaluate your Active Directory security posture

Start with a scoping conversation about your AD environment, domain structure, and security priorities.

Schedule a Scoping Call

Healthcare overview Ransomware pathway assessment Internal penetration testing