diff --git a/backend/.gitignore b/backend/.gitignore
new file mode 100644
index 0000000..a34ed7c
--- /dev/null
+++ b/backend/.gitignore
@@ -0,0 +1,65 @@
+# Environment
+.env
+.env.local
+.env.*.local
+
+# Python
+__pycache__/
+*.py[cod]
+*$py.class
+*.so
+.Python
+build/
+develop-eggs/
+dist/
+downloads/
+eggs/
+.eggs/
+lib/
+lib64/
+parts/
+sdist/
+var/
+wheels/
+pip-wheel-metadata/
+share/python-wheels/
+*.egg-info/
+.installed.cfg
+*.egg
+MANIFEST
+
+# Virtual environments
+venv/
+ENV/
+env/
+.venv
+
+# IDE
+.vscode/
+.idea/
+*.swp
+*.swo
+*~
+.DS_Store
+
+# Testing
+.pytest_cache/
+.coverage
+htmlcov/
+.tox/
+.hypothesis/
+
+# Database
+*.db
+*.sqlite
+*.sqlite3
+
+# Logs
+*.log
+logs/
+
+# Docker
+docker-compose.override.yml
+
+# Migrations (until created)
+migrations/versions/*.py
diff --git a/backend/Dockerfile b/backend/Dockerfile
new file mode 100644
index 0000000..ffcb568
--- /dev/null
+++ b/backend/Dockerfile
@@ -0,0 +1,52 @@
+# Multi-stage build for Python FastAPI backend
+# Job ID: MTAD-IMPL-2025-11-18-CL
+
+FROM python:3.11-slim as builder
+
+WORKDIR /app
+
+# Install build dependencies
+RUN apt-get update && apt-get install -y --no-install-recommends \
+    build-essential \
+    libpq-dev \
+    && rm -rf /var/lib/apt/lists/*
+
+# Copy requirements and install dependencies
+COPY requirements.txt .
+RUN pip install --user --no-cache-dir -r requirements.txt
+
+
+FROM python:3.11-slim
+
+WORKDIR /app
+
+# Install runtime dependencies only
+RUN apt-get update && apt-get install -y --no-install-recommends \
+    libpq5 \
+    curl \
+    && rm -rf /var/lib/apt/lists/*
+
+# Copy Python packages from builder
+COPY --from=builder /root/.local /root/.local
+
+# Set environment variables
+ENV PATH=/root/.local/bin:$PATH
+ENV PYTHONUNBUFFERED=1
+ENV PYTHONDONTWRITEBYTECODE=1
+
+# Copy application code
+COPY . .
+
+# Create non-root user for security
+RUN useradd -m -u 1000 appuser && chown -R appuser:appuser /app
+USER appuser
+
+# Health check
+HEALTHCHECK --interval=30s --timeout=10s --start-period=5s --retries=3 \
+    CMD curl -f http://localhost:8000/health || exit 1
+
+# Expose port
+EXPOSE 8000
+
+# Run application
+CMD ["uvicorn", "app.main:app", "--host", "0.0.0.0", "--port", "8000"]
diff --git a/backend/README.md b/backend/README.md
new file mode 100644
index 0000000..4868b64
--- /dev/null
+++ b/backend/README.md
@@ -0,0 +1,350 @@
+# MoreThanADiagnosis Backend API
+
+FastAPI backend for the MoreThanADiagnosis community platform.
+
+**Job ID**: MTAD-IMPL-2025-11-18-CL
+
+## 🏗 Architecture
+
+- **Framework**: FastAPI with Python 3.11
+- **Database**: PostgreSQL with SQLAlchemy ORM
+- **Cache**: Redis
+- **Deployment**: Docker + Docker Compose on nexus-vector
+
+## 📦 Project Structure
+
+```
+backend/
+├── app/
+│   ├── api/v1/              # API endpoints for 7 MVPs
+│   │   ├── blog.py
+│   │   ├── forum.py
+│   │   ├── merch.py
+│   │   ├── podcast.py
+│   │   ├── profiles.py
+│   │   ├── resources.py
+│   │   ├── tribute.py
+│   │   └── health.py
+│   ├── models/              # SQLAlchemy models (7 MVPs + auth)
+│   ├── schemas/             # Pydantic schemas (TODO)
+│   ├── services/            # Business logic (TODO)
+│   ├── middleware/          # Custom middleware (TODO)
+│   ├── utils/               # Utilities (TODO)
+│   ├── config.py            # Configuration
+│   ├── database.py          # Database setup
+│   └── main.py              # FastAPI app entry
+├── migrations/              # Alembic migrations (TODO)
+├── tests/                   # Unit and integration tests (TODO)
+├── Dockerfile               # Container image
+├── docker-compose.yml       # Local development setup
+├── requirements.txt         # Python dependencies
+└── .env.example             # Environment variables template
+```
+
+## 🚀 Quick Start
+
+### Prerequisites
+- Docker & Docker Compose
+- Python 3.11+ (for local development)
+- PostgreSQL (if not using Docker)
+
+### Local Development
+
+1. **Set up environment**
+   ```bash
+   cp .env.example .env
+   # Edit .env with your configuration
+   ```
+
+2. **Install dependencies**
+   ```bash
+   pip install -r requirements.txt
+   ```
+
+3. **Start services**
+   ```bash
+   docker-compose up -d
+   ```
+
+4. **Run migrations** (TODO)
+   ```bash
+   alembic upgrade head
+   ```
+
+5. **Start API**
+   ```bash
+   uvicorn app.main:app --reload --host 0.0.0.0 --port 8000
+   ```
+
+6. **Access API**
+   - API: http://localhost:8000
+   - Docs: http://localhost:8000/docs
+   - ReDoc: http://localhost:8000/redoc
+
+### Production Deployment (nexus-vector)
+
+1. **Copy to nexus-vector**
+   ```bash
+   scp -r backend/ admin@nexus-vector:/srv/containers/mtad-backend/
+   ```
+
+2. **Set production environment**
+   ```bash
+   ssh admin@nexus-vector
+   cd /srv/containers/mtad-backend
+   cp .env.example .env
+   # Edit .env with production secrets
+   ```
+
+3. **Deploy with Docker Compose**
+   ```bash
+   docker-compose up -d
+   ```
+
+4. **Verify health**
+   ```bash
+   curl http://100.95.3.92:8000/health
+   ```
+
+## 📋 MVPs Implemented (Alphabetically)
+
+### 1. Blog MVP
+- List published blog posts
+- Get individual posts by ID
+- (TODO) Create, update, delete posts with authentication
+
+### 2. Forum MVP
+- List categories
+- List threads per category
+- List posts per thread
+- (TODO) Create threads and posts with authentication
+- (TODO) Emoji reactions and moderation reports
+
+### 3. Merch MVP
+- List products
+- Get product details
+- List orders
+- (TODO) Create orders with authentication
+
+### 4. Podcast MVP
+- List episodes
+- Get episode details
+- (TODO) Upload and manage episodes
+
+### 5. Profiles MVP
+- Get user profile
+- List public profiles
+- (TODO) Update profile with authentication
+
+### 6. Resources MVP
+- List resources by access tier
+- Get resources by ID or slug
+- (TODO) Create resources with authorization
+
+### 7. Tribute MVP
+- List published tributes
+- Get tribute details
+- (TODO) Create tributes with authentication
+
+## 🔐 Authentication & Authorization
+
+**Status**: Specification approved (openspec/specs/authentication.md)
+
+**TODO Implementation**:
+- OAuth2/OIDC with PKCE
+- JWT access tokens (15 min expiry)
+- Refresh tokens with rotation (30 day expiry)
+- RBAC: member, moderator, admin roles
+- MFA (TOTP) support
+- Password reset flow
+- Account lockout protection
+
+## 🗄 Database
+
+**Status**: Schema specified (openspec/specs/data-model.md)
+
+**Core Entities**:
+- User (with email verification, MFA)
+- Profile (display name, pseudonym, health journey)
+- Forum (categories, threads, posts, reactions, reports)
+- Blog (posts)
+- Podcast (episodes)
+- Resources (knowledge base)
+- Tribute (memorials)
+- Merch (products, orders)
+- Consent (privacy compliance)
+
+**Data Classification**:
+- Public: Forum categories, public resources, published blog/podcast
+- PII: Email, display names, shipping addresses, avatars
+- PHI: Health journey, forum content (context-dependent), memorials
+
+## 📊 API Endpoints
+
+All endpoints use `/api/v1/` prefix.
+
+### Blog
+- `GET /api/v1/blog/` - List posts
+- `GET /api/v1/blog/{post_id}` - Get post
+
+### Forum
+- `GET /api/v1/forum/categories` - List categories
+- `GET /api/v1/forum/categories/{cat_id}/threads` - List threads
+- `GET /api/v1/forum/threads/{thread_id}/posts` - List posts
+
+### Merch
+- `GET /api/v1/merch/products` - List products
+- `GET /api/v1/merch/products/{id}` - Get product
+- `GET /api/v1/merch/orders/{id}` - Get order
+
+### Podcast
+- `GET /api/v1/podcast/episodes` - List episodes
+- `GET /api/v1/podcast/episodes/{id}` - Get episode
+
+### Profiles
+- `GET /api/v1/profiles/{user_id}` - Get profile
+- `GET /api/v1/profiles/` - List public profiles
+
+### Resources
+- `GET /api/v1/resources/` - List resources
+- `GET /api/v1/resources/{id}` - Get resource
+- `GET /api/v1/resources/slug/{slug}` - Get by slug
+
+### Tribute
+- `GET /api/v1/tribute/` - List tributes
+- `GET /api/v1/tribute/{id}` - Get tribute
+
+### Health
+- `GET /api/v1/health` - Health check
+- `GET /api/v1/ready` - Readiness check
+
+## 🧪 Testing
+
+**Status**: Test infrastructure ready (pytest, pytest-asyncio)
+
+**TODO**:
+- Unit tests for models
+- Integration tests for endpoints
+- API contract tests
+- Load testing
+
+```bash
+# Run tests
+pytest tests/ -v
+
+# Coverage report
+pytest tests/ --cov=app --cov-report=html
+```
+
+## 🔄 Database Migrations
+
+**Status**: Alembic configured, no migrations yet
+
+```bash
+# Create migration
+alembic revision --autogenerate -m "Add forum tables"
+
+# Apply migrations
+alembic upgrade head
+
+# Rollback
+alembic downgrade -1
+```
+
+## 📝 Development Checklist
+
+### Phase 1: Foundation (Current)
+- [x] FastAPI project structure
+- [x] Database models for all 7 MVPs
+- [x] API endpoint stubs
+- [x] Docker configuration
+- [ ] Environment configuration finalization
+- [ ] Database migrations
+- [ ] Test infrastructure setup
+
+### Phase 2: Authentication (Next)
+- [ ] User registration/login
+- [ ] Email verification
+- [ ] Password hashing (Argon2)
+- [ ] JWT token generation
+- [ ] RBAC middleware
+- [ ] MFA setup
+
+### Phase 3: MVP Implementation
+- [ ] Blog: Full CRUD with publishing
+- [ ] Forum: Threading, moderation, reporting
+- [ ] Merch: Shopping cart, checkout
+- [ ] Podcast: Upload, streaming
+- [ ] Profiles: User data management
+- [ ] Resources: Knowledge base
+- [ ] Tribute: Memorial management
+
+### Phase 4: Integration & Deployment
+- [ ] Frontend integration (Next.js web)
+- [ ] Mobile integration (React Native/Expo)
+- [ ] Production deployment
+- [ ] Monitoring & alerting
+- [ ] Performance optimization
+
+## 🛠 Configuration
+
+See `.env.example` for all available environment variables.
+
+**Key Production Variables**:
+```
+ENV=production
+DEBUG=false
+DATABASE_URL=postgresql://user:pass@host:5432/db
+SECRET_KEY=<generate-with-secrets>
+CORS_ORIGINS=["https://morethanadiagnosis.com"]
+```
+
+## 📚 Documentation
+
+- **OpenAPI/Swagger**: http://localhost:8000/docs
+- **ReDoc**: http://localhost:8000/redoc
+- **Architecture Spec**: ../../openspec/specs/architecture.md
+- **Data Model**: ../../openspec/specs/data-model.md
+- **Authentication Spec**: ../../openspec/specs/authentication.md
+- **Design System**: ../../openspec/specs/design-system.md
+
+## 🚨 Known Issues
+
+- [ ] Authentication not implemented yet
+- [ ] Database migrations not created yet
+- [ ] Request/response schemas not defined
+- [ ] Error handling needs standardization
+- [ ] Logging configuration needs refinement
+- [ ] Rate limiting not configured
+- [ ] CORS not finalized for production
+
+## 📦 Dependencies
+
+See `requirements.txt` for full list. Key dependencies:
+
+- **fastapi** - Web framework
+- **sqlalchemy** - ORM
+- **alembic** - Migrations
+- **pydantic** - Validation
+- **passlib/argon2-cffi** - Password hashing
+- **python-jose** - JWT
+- **pytest** - Testing
+- **uvicorn** - ASGI server
+
+## 🤝 Contributing
+
+1. Follow OpenSpec lifecycle (propose → review → apply → archive)
+2. Ensure all code links to approved specs
+3. Add tests for new features
+4. Update documentation
+5. Follow Python/FastAPI best practices
+
+## 📄 License
+
+Part of MoreThanADiagnosis community platform.
+
+---
+
+**Status**: Foundation complete, MVP implementation ready
+**Next Action**: Database migrations + authentication implementation
+**Job ID**: MTAD-IMPL-2025-11-18-CL
diff --git a/backend/app/api/__init__.py b/backend/app/api/__init__.py
new file mode 100644
index 0000000..dff53e5
--- /dev/null
+++ b/backend/app/api/__init__.py
@@ -0,0 +1 @@
+"""API package."""
diff --git a/backend/app/api/v1/__init__.py b/backend/app/api/v1/__init__.py
new file mode 100644
index 0000000..0c9c42d
--- /dev/null
+++ b/backend/app/api/v1/__init__.py
@@ -0,0 +1,22 @@
+"""
+API v1 router aggregation.
+
+Job ID: MTAD-IMPL-2025-11-18-CL
+"""
+
+from fastapi import APIRouter
+from app.api.v1 import blog, forum, merch, podcast, profiles, resources, tribute, health
+
+api_router = APIRouter()
+
+# Include routers for all 7 MVPs
+api_router.include_router(blog.router, prefix="/blog", tags=["Blog"])
+api_router.include_router(forum.router, prefix="/forum", tags=["Forum"])
+api_router.include_router(merch.router, prefix="/merch", tags=["Merch"])
+api_router.include_router(podcast.router, prefix="/podcast", tags=["Podcast"])
+api_router.include_router(profiles.router, prefix="/profiles", tags=["Profiles"])
+api_router.include_router(resources.router, prefix="/resources", tags=["Resources"])
+api_router.include_router(tribute.router, prefix="/tribute", tags=["Tribute"])
+api_router.include_router(health.router, tags=["Health"])
+
+__all__ = ["api_router"]
diff --git a/backend/app/api/v1/blog.py b/backend/app/api/v1/blog.py
new file mode 100644
index 0000000..fad9480
--- /dev/null
+++ b/backend/app/api/v1/blog.py
@@ -0,0 +1,49 @@
+"""
+Blog MVP API endpoints.
+
+Job ID: MTAD-IMPL-2025-11-18-CL
+"""
+
+from fastapi import APIRouter, Depends, HTTPException, status
+from sqlalchemy.orm import Session
+from app.database import get_db
+from app.models import BlogPost
+
+router = APIRouter()
+
+
+@router.get("/")
+async def list_blog_posts(skip: int = 0, limit: int = 10, db: Session = Depends(get_db)):
+    """List all published blog posts."""
+    posts = db.query(BlogPost).filter(BlogPost.published_at.isnot(None)).offset(skip).limit(limit).all()
+    return {"items": posts, "count": len(posts)}
+
+
+@router.get("/{post_id}")
+async def get_blog_post(post_id: str, db: Session = Depends(get_db)):
+    """Get a specific blog post by ID."""
+    post = db.query(BlogPost).filter(BlogPost.id == post_id).first()
+    if not post:
+        raise HTTPException(status_code=status.HTTP_404_NOT_FOUND, detail="Blog post not found")
+    return post
+
+
+@router.post("/")
+async def create_blog_post(title: str, slug: str, content: str, db: Session = Depends(get_db)):
+    """Create a new blog post (requires authentication)."""
+    # TODO: Implement with proper auth and validation
+    return {"message": "Blog post creation not yet implemented"}
+
+
+@router.put("/{post_id}")
+async def update_blog_post(post_id: str, title: str, content: str, db: Session = Depends(get_db)):
+    """Update a blog post (requires authentication and ownership)."""
+    # TODO: Implement with proper auth and validation
+    return {"message": "Blog post update not yet implemented"}
+
+
+@router.delete("/{post_id}")
+async def delete_blog_post(post_id: str, db: Session = Depends(get_db)):
+    """Delete a blog post (requires authentication and ownership)."""
+    # TODO: Implement with proper auth and validation
+    return {"message": "Blog post deletion not yet implemented"}
diff --git a/backend/app/api/v1/forum.py b/backend/app/api/v1/forum.py
new file mode 100644
index 0000000..81ed3dd
--- /dev/null
+++ b/backend/app/api/v1/forum.py
@@ -0,0 +1,40 @@
+"""Forum MVP API endpoints. Job ID: MTAD-IMPL-2025-11-18-CL"""
+from fastapi import APIRouter, Depends, HTTPException, status
+from sqlalchemy.orm import Session
+from app.database import get_db
+from app.models import ForumCategory, ForumThread, ForumPost
+
+router = APIRouter()
+
+@router.get("/categories")
+async def list_categories(db: Session = Depends(get_db)):
+    """List all forum categories."""
+    categories = db.query(ForumCategory).order_by(ForumCategory.order).all()
+    return {"items": categories}
+
+@router.get("/categories/{category_id}/threads")
+async def list_threads(category_id: str, skip: int = 0, limit: int = 10, db: Session = Depends(get_db)):
+    """List threads in a category."""
+    threads = db.query(ForumThread).filter(ForumThread.category_id == category_id).offset(skip).limit(limit).all()
+    return {"items": threads}
+
+@router.get("/threads/{thread_id}/posts")
+async def list_posts(thread_id: str, skip: int = 0, limit: int = 20, db: Session = Depends(get_db)):
+    """List posts in a thread."""
+    posts = db.query(ForumPost).filter(ForumPost.thread_id == thread_id, ForumPost.deleted_at.is_(None)).offset(skip).limit(limit).all()
+    return {"items": posts}
+
+@router.post("/categories")
+async def create_category(name: str, db: Session = Depends(get_db)):
+    """Create forum category (admin only)."""
+    return {"message": "Category creation not yet implemented"}
+
+@router.post("/threads")
+async def create_thread(category_id: str, title: str, db: Session = Depends(get_db)):
+    """Create forum thread (requires authentication)."""
+    return {"message": "Thread creation not yet implemented"}
+
+@router.post("/posts")
+async def create_post(thread_id: str, content: str, db: Session = Depends(get_db)):
+    """Create forum post (requires authentication)."""
+    return {"message": "Post creation not yet implemented"}
diff --git a/backend/app/api/v1/health.py b/backend/app/api/v1/health.py
new file mode 100644
index 0000000..2b32503
--- /dev/null
+++ b/backend/app/api/v1/health.py
@@ -0,0 +1,14 @@
+"""Health check endpoint. Job ID: MTAD-IMPL-2025-11-18-CL"""
+from fastapi import APIRouter
+
+router = APIRouter()
+
+@router.get("/health")
+async def health_check():
+    """Health check for uptime monitoring."""
+    return {"status": "healthy", "service": "MoreThanADiagnosis API"}
+
+@router.get("/ready")
+async def readiness_check():
+    """Readiness check for load balancer."""
+    return {"status": "ready"}
diff --git a/backend/app/api/v1/merch.py b/backend/app/api/v1/merch.py
new file mode 100644
index 0000000..91b3eb0
--- /dev/null
+++ b/backend/app/api/v1/merch.py
@@ -0,0 +1,39 @@
+"""Merch MVP API endpoints. Job ID: MTAD-IMPL-2025-11-18-CL"""
+from fastapi import APIRouter, Depends, HTTPException, status
+from sqlalchemy.orm import Session
+from app.database import get_db
+from app.models import MerchProduct, Order
+
+router = APIRouter()
+
+@router.get("/products")
+async def list_products(skip: int = 0, limit: int = 20, db: Session = Depends(get_db)):
+    """List all merch products."""
+    products = db.query(MerchProduct).offset(skip).limit(limit).all()
+    return {"items": products}
+
+@router.get("/products/{product_id}")
+async def get_product(product_id: str, db: Session = Depends(get_db)):
+    """Get a specific product."""
+    product = db.query(MerchProduct).filter(MerchProduct.id == product_id).first()
+    if not product:
+        raise HTTPException(status_code=status.HTTP_404_NOT_FOUND, detail="Product not found")
+    return product
+
+@router.get("/orders/{order_id}")
+async def get_order(order_id: str, db: Session = Depends(get_db)):
+    """Get order details."""
+    order = db.query(Order).filter(Order.id == order_id).first()
+    if not order:
+        raise HTTPException(status_code=status.HTTP_404_NOT_FOUND, detail="Order not found")
+    return order
+
+@router.post("/products")
+async def create_product(name: str, price: float, db: Session = Depends(get_db)):
+    """Create product (admin only)."""
+    return {"message": "Product creation not yet implemented"}
+
+@router.post("/orders")
+async def create_order(items: list, db: Session = Depends(get_db)):
+    """Create order (requires authentication)."""
+    return {"message": "Order creation not yet implemented"}
diff --git a/backend/app/api/v1/podcast.py b/backend/app/api/v1/podcast.py
new file mode 100644
index 0000000..2ef2cf4
--- /dev/null
+++ b/backend/app/api/v1/podcast.py
@@ -0,0 +1,27 @@
+"""Podcast MVP API endpoints. Job ID: MTAD-IMPL-2025-11-18-CL"""
+from fastapi import APIRouter, Depends
+from sqlalchemy.orm import Session
+from app.database import get_db
+from app.models import PodcastEpisode
+
+router = APIRouter()
+
+@router.get("/episodes")
+async def list_episodes(skip: int = 0, limit: int = 20, db: Session = Depends(get_db)):
+    """List all podcast episodes."""
+    episodes = db.query(PodcastEpisode).filter(PodcastEpisode.published_at.isnot(None)).order_by(PodcastEpisode.published_at.desc()).offset(skip).limit(limit).all()
+    return {"items": episodes}
+
+@router.get("/episodes/{episode_id}")
+async def get_episode(episode_id: str, db: Session = Depends(get_db)):
+    """Get a specific episode."""
+    episode = db.query(PodcastEpisode).filter(PodcastEpisode.id == episode_id).first()
+    if not episode:
+        from fastapi import HTTPException, status
+        raise HTTPException(status_code=status.HTTP_404_NOT_FOUND, detail="Episode not found")
+    return episode
+
+@router.post("/episodes")
+async def create_episode(title: str, audio_url: str, db: Session = Depends(get_db)):
+    """Create podcast episode (admin only)."""
+    return {"message": "Episode creation not yet implemented"}
diff --git a/backend/app/api/v1/profiles.py b/backend/app/api/v1/profiles.py
new file mode 100644
index 0000000..0d1e7fd
--- /dev/null
+++ b/backend/app/api/v1/profiles.py
@@ -0,0 +1,26 @@
+"""Profiles MVP API endpoints. Job ID: MTAD-IMPL-2025-11-18-CL"""
+from fastapi import APIRouter, Depends, HTTPException, status
+from sqlalchemy.orm import Session
+from app.database import get_db
+from app.models import User, Profile
+
+router = APIRouter()
+
+@router.get("/{user_id}")
+async def get_profile(user_id: str, db: Session = Depends(get_db)):
+    """Get user profile."""
+    profile = db.query(Profile).filter(Profile.user_id == user_id).first()
+    if not profile:
+        raise HTTPException(status_code=status.HTTP_404_NOT_FOUND, detail="Profile not found")
+    return profile
+
+@router.put("/{user_id}")
+async def update_profile(user_id: str, display_name: str = None, bio: str = None, db: Session = Depends(get_db)):
+    """Update profile (requires authentication)."""
+    return {"message": "Profile update not yet implemented"}
+
+@router.get("/")
+async def list_public_profiles(skip: int = 0, limit: int = 20, db: Session = Depends(get_db)):
+    """List public user profiles."""
+    profiles = db.query(Profile).offset(skip).limit(limit).all()
+    return {"items": profiles}
diff --git a/backend/app/api/v1/resources.py b/backend/app/api/v1/resources.py
new file mode 100644
index 0000000..dd07342
--- /dev/null
+++ b/backend/app/api/v1/resources.py
@@ -0,0 +1,34 @@
+"""Resources MVP API endpoints. Job ID: MTAD-IMPL-2025-11-18-CL"""
+from fastapi import APIRouter, Depends, HTTPException, status
+from sqlalchemy.orm import Session
+from app.database import get_db
+from app.models import Resource
+
+router = APIRouter()
+
+@router.get("/")
+async def list_resources(access_tier: str = "public", skip: int = 0, limit: int = 20, db: Session = Depends(get_db)):
+    """List resources by access tier."""
+    resources = db.query(Resource).filter(Resource.access_tier == access_tier).offset(skip).limit(limit).all()
+    return {"items": resources}
+
+@router.get("/{resource_id}")
+async def get_resource(resource_id: str, db: Session = Depends(get_db)):
+    """Get a specific resource."""
+    resource = db.query(Resource).filter(Resource.id == resource_id).first()
+    if not resource:
+        raise HTTPException(status_code=status.HTTP_404_NOT_FOUND, detail="Resource not found")
+    return resource
+
+@router.get("/slug/{slug}")
+async def get_resource_by_slug(slug: str, db: Session = Depends(get_db)):
+    """Get resource by slug."""
+    resource = db.query(Resource).filter(Resource.slug == slug).first()
+    if not resource:
+        raise HTTPException(status_code=status.HTTP_404_NOT_FOUND, detail="Resource not found")
+    return resource
+
+@router.post("/")
+async def create_resource(title: str, slug: str, content: str, db: Session = Depends(get_db)):
+    """Create resource (admin or authorized user)."""
+    return {"message": "Resource creation not yet implemented"}
diff --git a/backend/app/api/v1/tribute.py b/backend/app/api/v1/tribute.py
new file mode 100644
index 0000000..1ee8624
--- /dev/null
+++ b/backend/app/api/v1/tribute.py
@@ -0,0 +1,31 @@
+"""Tribute MVP API endpoints. Job ID: MTAD-IMPL-2025-11-18-CL"""
+from fastapi import APIRouter, Depends, HTTPException, status
+from sqlalchemy.orm import Session
+from app.database import get_db
+from app.models import TributeEntry
+
+router = APIRouter()
+
+@router.get("/")
+async def list_tributes(skip: int = 0, limit: int = 20, db: Session = Depends(get_db)):
+    """List published tribute entries."""
+    entries = db.query(TributeEntry).filter(TributeEntry.published == True).offset(skip).limit(limit).all()
+    return {"items": entries}
+
+@router.get("/{tribute_id}")
+async def get_tribute(tribute_id: str, db: Session = Depends(get_db)):
+    """Get a specific tribute entry."""
+    entry = db.query(TributeEntry).filter(TributeEntry.id == tribute_id, TributeEntry.published == True).first()
+    if not entry:
+        raise HTTPException(status_code=status.HTTP_404_NOT_FOUND, detail="Tribute not found")
+    return entry
+
+@router.post("/")
+async def create_tribute(subject_name: str, memorial_text: str, db: Session = Depends(get_db)):
+    """Create tribute entry (requires authentication)."""
+    return {"message": "Tribute creation not yet implemented"}
+
+@router.put("/{tribute_id}")
+async def update_tribute(tribute_id: str, memorial_text: str = None, db: Session = Depends(get_db)):
+    """Update tribute (requires authentication and ownership)."""
+    return {"message": "Tribute update not yet implemented"}
diff --git a/backend/app/config.py b/backend/app/config.py
new file mode 100644
index 0000000..a2397f4
--- /dev/null
+++ b/backend/app/config.py
@@ -0,0 +1,86 @@
+"""
+Application configuration using Pydantic Settings.
+
+Job ID: MTAD-IMPL-2025-11-18-CL
+"""
+
+from typing import List
+from pydantic_settings import BaseSettings
+
+
+class Settings(BaseSettings):
+    """Application settings loaded from environment variables."""
+
+    # Environment
+    env: str = "development"
+    debug: bool = False
+
+    # API
+    api_version: str = "v1"
+    api_title: str = "MoreThanADiagnosis API"
+    api_description: str = "Community Hub for Chronically/Terminally Ill Individuals"
+
+    # Database
+    database_url: str = "sqlite:///./test.db"
+    database_pool_size: int = 20
+    database_max_overflow: int = 10
+
+    # Security
+    secret_key: str = "change-me-in-production"
+    algorithm: str = "HS256"
+    access_token_expire_minutes: int = 15
+    refresh_token_expire_days: int = 30
+    password_hashing_algorithm: str = "argon2"
+
+    # CORS
+    cors_origins: List[str] = [
+        "https://morethanadiagnosis.com",
+        "http://localhost:3000",
+        "http://localhost:8081",
+    ]
+    cors_credentials: bool = True
+    cors_methods: List[str] = ["*"]
+    cors_headers: List[str] = ["*"]
+
+    # Logging
+    log_level: str = "INFO"
+    log_format: str = "json"
+
+    # Observability
+    jaeger_enabled: bool = False
+    jaeger_host: str = "localhost"
+    jaeger_port: int = 6831
+
+    # Rate Limiting
+    rate_limit_enabled: bool = True
+    rate_limit_requests: int = 100
+    rate_limit_period: int = 60
+
+    # Redis
+    redis_url: str = "redis://localhost:6379/0"
+
+    # Email
+    smtp_server: str = "smtp.gmail.com"
+    smtp_port: int = 587
+    smtp_username: str = "noreply@morethanadiagnosis.com"
+    smtp_password: str = ""
+    smtp_from: str = "noreply@morethanadiagnosis.com"
+
+    # File Storage
+    storage_type: str = "s3"
+    s3_bucket: str = "morethanadiagnosis-media"
+    s3_region: str = "us-east-1"
+    s3_access_key: str = ""
+    s3_secret_key: str = ""
+
+    # Feature Flags
+    feature_mfa_enabled: bool = True
+    feature_social_login_enabled: bool = False
+    feature_pseudonym_enabled: bool = True
+
+    class Config:
+        env_file = ".env"
+        case_sensitive = False
+
+
+settings = Settings()
diff --git a/backend/app/database.py b/backend/app/database.py
new file mode 100644
index 0000000..671d982
--- /dev/null
+++ b/backend/app/database.py
@@ -0,0 +1,64 @@
+"""
+Database configuration and session management.
+
+Job ID: MTAD-IMPL-2025-11-18-CL
+"""
+
+from sqlalchemy import create_engine, event
+from sqlalchemy.engine import Engine
+from sqlalchemy.orm import declarative_base, sessionmaker
+from app.config import settings
+import logging
+
+logger = logging.getLogger(__name__)
+
+# Create database engine with connection pooling
+engine = create_engine(
+    settings.database_url,
+    poolclass=None if "sqlite" in settings.database_url else None,
+    pool_size=settings.database_pool_size,
+    max_overflow=settings.database_max_overflow,
+    echo=settings.debug,
+    future=True,
+)
+
+# Session factory
+SessionLocal = sessionmaker(autocommit=False, autoflush=False, bind=engine)
+
+# Base class for models
+Base = declarative_base()
+
+
+# Event listeners for PostgreSQL
+@event.listens_for(Engine, "connect")
+def set_sqlite_pragma(dbapi_conn, connection_record):
+    """Enable foreign keys for SQLite (if using SQLite)."""
+    if "sqlite" in settings.database_url:
+        cursor = dbapi_conn.cursor()
+        cursor.execute("PRAGMA foreign_keys=ON")
+        cursor.close()
+
+
+def get_db():
+    """Dependency for FastAPI to get database session."""
+    db = SessionLocal()
+    try:
+        yield db
+    finally:
+        db.close()
+
+
+async def init_db():
+    """Initialize database tables."""
+    try:
+        Base.metadata.create_all(bind=engine)
+        logger.info("Database tables created successfully")
+    except Exception as e:
+        logger.error(f"Error initializing database: {e}")
+        raise
+
+
+async def close_db():
+    """Close database connections."""
+    engine.dispose()
+    logger.info("Database connections closed")
diff --git a/backend/app/main.py b/backend/app/main.py
new file mode 100644
index 0000000..cf3e838
--- /dev/null
+++ b/backend/app/main.py
@@ -0,0 +1,88 @@
+"""
+FastAPI main application entry point.
+
+Job ID: MTAD-IMPL-2025-11-18-CL
+"""
+
+import logging
+from contextlib import asynccontextmanager
+from fastapi import FastAPI
+from fastapi.middleware.cors import CORSMiddleware
+from app.config import settings
+from app.database import init_db, close_db
+from app.api.v1 import api_router
+
+# Configure logging
+logging.basicConfig(
+    level=settings.log_level,
+    format='%(asctime)s - %(name)s - %(levelname)s - %(message)s'
+)
+logger = logging.getLogger(__name__)
+
+
+@asynccontextmanager
+async def lifespan(app: FastAPI):
+    """Lifespan context manager for startup and shutdown events."""
+    # Startup
+    logger.info("Starting MoreThanADiagnosis API")
+    await init_db()
+    logger.info("Database initialized")
+    yield
+    # Shutdown
+    logger.info("Shutting down MoreThanADiagnosis API")
+    await close_db()
+    logger.info("Database connections closed")
+
+
+# Create FastAPI app
+app = FastAPI(
+    title=settings.api_title,
+    description=settings.api_description,
+    version=settings.api_version,
+    lifespan=lifespan,
+)
+
+# Add CORS middleware
+app.add_middleware(
+    CORSMiddleware,
+    allow_origins=settings.cors_origins,
+    allow_credentials=settings.cors_credentials,
+    allow_methods=settings.cors_methods,
+    allow_headers=settings.cors_headers,
+)
+
+# Include API routes
+app.include_router(api_router, prefix=f"/api/{settings.api_version}")
+
+
+# Health check endpoint
+@app.get("/health", tags=["Health"])
+async def health_check():
+    """Health check endpoint for uptime monitoring."""
+    return {
+        "status": "healthy",
+        "version": settings.api_version,
+        "env": settings.env,
+    }
+
+
+@app.get("/", tags=["Root"])
+async def root():
+    """Root endpoint."""
+    return {
+        "service": settings.api_title,
+        "version": settings.api_version,
+        "docs": "/docs",
+        "redoc": "/redoc",
+    }
+
+
+if __name__ == "__main__":
+    import uvicorn
+    uvicorn.run(
+        "app.main:app",
+        host="0.0.0.0",
+        port=8000,
+        reload=settings.debug,
+        log_level=settings.log_level.lower(),
+    )
diff --git a/backend/app/models/__init__.py b/backend/app/models/__init__.py
new file mode 100644
index 0000000..514546f
--- /dev/null
+++ b/backend/app/models/__init__.py
@@ -0,0 +1,48 @@
+"""
+SQLAlchemy models package.
+
+Job ID: MTAD-IMPL-2025-11-18-CL
+"""
+
+from app.models.user import User, Profile, Role, UserRole, Consent
+from app.models.authentication import RefreshToken, AuthAuditLog
+from app.models.forum import (
+    ForumCategory,
+    ForumThread,
+    ForumPost,
+    ForumReaction,
+    ForumReport,
+)
+from app.models.blog import BlogPost
+from app.models.podcast import PodcastEpisode
+from app.models.resources import Resource
+from app.models.tribute import TributeEntry
+from app.models.merch import MerchProduct, Order
+
+__all__ = [
+    # User & Auth
+    "User",
+    "Profile",
+    "Role",
+    "UserRole",
+    "Consent",
+    "RefreshToken",
+    "AuthAuditLog",
+    # Forum
+    "ForumCategory",
+    "ForumThread",
+    "ForumPost",
+    "ForumReaction",
+    "ForumReport",
+    # Blog
+    "BlogPost",
+    # Podcast
+    "PodcastEpisode",
+    # Resources
+    "Resource",
+    # Tribute
+    "TributeEntry",
+    # Merch
+    "MerchProduct",
+    "Order",
+]
diff --git a/backend/app/models/authentication.py b/backend/app/models/authentication.py
new file mode 100644
index 0000000..7055c7d
--- /dev/null
+++ b/backend/app/models/authentication.py
@@ -0,0 +1,42 @@
+"""
+Authentication models - RefreshToken and AuthAuditLog.
+
+Job ID: MTAD-IMPL-2025-11-18-CL
+"""
+
+from sqlalchemy import Column, String, DateTime, ForeignKey, Integer
+from sqlalchemy.orm import relationship
+from sqlalchemy.sql import func
+from app.database import Base
+
+
+class RefreshToken(Base):
+    """Refresh Token entity - Session management."""
+
+    __tablename__ = "refresh_tokens"
+
+    id = Column(String(36), primary_key=True, index=True)
+    user_id = Column(String(36), ForeignKey("users.id"), index=True, nullable=False)
+    token_hash = Column(String(255), unique=True, nullable=False)
+    expires_at = Column(DateTime, nullable=False, index=True)
+    created_at = Column(DateTime, server_default=func.now())
+    revoked_at = Column(DateTime, nullable=True)
+
+    # Relationships
+    user = relationship("User", back_populates="refresh_tokens")
+
+
+class AuthAuditLog(Base):
+    """Auth Audit Log - Compliance and security auditing."""
+
+    __tablename__ = "auth_audit_logs"
+
+    id = Column(String(36), primary_key=True, index=True)
+    user_id = Column(String(36), ForeignKey("users.id"), index=True, nullable=True)
+    event_type = Column(String(50), index=True, nullable=False)  # signup, login_success, login_fail, password_reset, mfa_enable, etc.
+    ip_address = Column(String(45), nullable=True)
+    user_agent = Column(String(500), nullable=True)
+    created_at = Column(DateTime, server_default=func.now(), index=True)
+
+    # Relationships
+    user = relationship("User", back_populates="audit_logs")
diff --git a/backend/app/models/blog.py b/backend/app/models/blog.py
new file mode 100644
index 0000000..974792b
--- /dev/null
+++ b/backend/app/models/blog.py
@@ -0,0 +1,29 @@
+"""
+Blog MVP model - BlogPost.
+
+Job ID: MTAD-IMPL-2025-11-18-CL
+"""
+
+from sqlalchemy import Column, String, Text, DateTime, ForeignKey
+from sqlalchemy.orm import relationship
+from sqlalchemy.sql import func
+from app.database import Base
+
+
+class BlogPost(Base):
+    """Blog Post - Published articles and content."""
+
+    __tablename__ = "blog_posts"
+
+    id = Column(String(36), primary_key=True, index=True)
+    author_id = Column(String(36), ForeignKey("users.id"), index=True, nullable=False)
+    title = Column(String(500), nullable=False, index=True)
+    slug = Column(String(500), unique=True, index=True, nullable=False)
+    content = Column(Text, nullable=False)
+    excerpt = Column(Text, nullable=True)
+    published_at = Column(DateTime, nullable=True, index=True)
+    created_at = Column(DateTime, server_default=func.now(), index=True)
+    updated_at = Column(DateTime, server_default=func.now(), onupdate=func.now(), index=True)
+
+    # Relationships
+    author = relationship("User", back_populates="blog_posts")
diff --git a/backend/app/models/forum.py b/backend/app/models/forum.py
new file mode 100644
index 0000000..ab7ef9b
--- /dev/null
+++ b/backend/app/models/forum.py
@@ -0,0 +1,102 @@
+"""
+Forum MVP models - Categories, Threads, Posts, Reactions, Reports.
+
+Job ID: MTAD-IMPL-2025-11-18-CL
+"""
+
+from sqlalchemy import Column, String, Text, Boolean, DateTime, Integer, ForeignKey
+from sqlalchemy.orm import relationship
+from sqlalchemy.sql import func
+from app.database import Base
+
+
+class ForumCategory(Base):
+    """Forum Category - Discussion categories."""
+
+    __tablename__ = "forum_categories"
+
+    id = Column(String(36), primary_key=True, index=True)
+    name = Column(String(255), unique=True, nullable=False, index=True)
+    description = Column(Text, nullable=True)
+    order = Column(Integer, default=0, index=True)
+    created_at = Column(DateTime, server_default=func.now())
+    updated_at = Column(DateTime, server_default=func.now(), onupdate=func.now())
+
+    # Relationships
+    threads = relationship("ForumThread", back_populates="category", cascade="all, delete-orphan")
+
+
+class ForumThread(Base):
+    """Forum Thread - Discussion thread."""
+
+    __tablename__ = "forum_threads"
+
+    id = Column(String(36), primary_key=True, index=True)
+    category_id = Column(String(36), ForeignKey("forum_categories.id"), index=True, nullable=False)
+    author_id = Column(String(36), ForeignKey("users.id"), index=True, nullable=False)
+    title = Column(String(500), nullable=False, index=True)
+    pinned = Column(Boolean, default=False, index=True)
+    locked = Column(Boolean, default=False, index=True)
+    created_at = Column(DateTime, server_default=func.now(), index=True)
+    updated_at = Column(DateTime, server_default=func.now(), onupdate=func.now(), index=True)
+
+    # Relationships
+    category = relationship("ForumCategory", back_populates="threads")
+    author = relationship("User", back_populates="forum_threads")
+    posts = relationship("ForumPost", back_populates="thread", cascade="all, delete-orphan")
+
+
+class ForumPost(Base):
+    """Forum Post - Individual post/reply in a thread."""
+
+    __tablename__ = "forum_posts"
+
+    id = Column(String(36), primary_key=True, index=True)
+    thread_id = Column(String(36), ForeignKey("forum_threads.id"), index=True, nullable=False)
+    author_id = Column(String(36), ForeignKey("users.id"), index=True, nullable=False)
+    parent_post_id = Column(String(36), ForeignKey("forum_posts.id"), index=True, nullable=True)
+    content = Column(Text, nullable=False)  # May contain PHI
+    deleted_at = Column(DateTime, nullable=True)
+    created_at = Column(DateTime, server_default=func.now(), index=True)
+    updated_at = Column(DateTime, server_default=func.now(), onupdate=func.now(), index=True)
+
+    # Relationships
+    thread = relationship("ForumThread", back_populates="posts")
+    author = relationship("User", back_populates="forum_posts")
+    reactions = relationship("ForumReaction", back_populates="post", cascade="all, delete-orphan")
+    reports = relationship("ForumReport", back_populates="post", cascade="all, delete-orphan")
+
+
+class ForumReaction(Base):
+    """Forum Reaction - Emoji reactions to posts."""
+
+    __tablename__ = "forum_reactions"
+
+    id = Column(String(36), primary_key=True, index=True)
+    post_id = Column(String(36), ForeignKey("forum_posts.id"), index=True, nullable=False)
+    user_id = Column(String(36), ForeignKey("users.id"), index=True, nullable=False)
+    emoji_code = Column(String(20), nullable=False)  # e.g., "👍", "❤️", "😢"
+    created_at = Column(DateTime, server_default=func.now(), index=True)
+
+    # Relationships
+    post = relationship("ForumPost", back_populates="reactions")
+    user = relationship("User", back_populates="forum_reactions")
+
+
+class ForumReport(Base):
+    """Forum Report - Content moderation reports."""
+
+    __tablename__ = "forum_reports"
+
+    id = Column(String(36), primary_key=True, index=True)
+    post_id = Column(String(36), ForeignKey("forum_posts.id"), index=True, nullable=False)
+    reporter_id = Column(String(36), ForeignKey("users.id"), index=True, nullable=False)
+    reason = Column(String(255), nullable=False)
+    status = Column(String(50), default="open", index=True)  # open, resolved, dismissed
+    moderator_notes = Column(Text, nullable=True)
+    resolved_at = Column(DateTime, nullable=True)
+    created_at = Column(DateTime, server_default=func.now(), index=True)
+
+    # Relationships
+    post = relationship("ForumPost", back_populates="reports")
+    reporter = relationship("User", back_populates="forum_reports")
diff --git a/backend/app/models/merch.py b/backend/app/models/merch.py
new file mode 100644
index 0000000..f04ff32
--- /dev/null
+++ b/backend/app/models/merch.py
@@ -0,0 +1,63 @@
+"""
+Merch MVP models - MerchProduct and Order for commerce.
+
+Job ID: MTAD-IMPL-2025-11-18-CL
+"""
+
+from sqlalchemy import Column, String, Text, Integer, Float, DateTime, ForeignKey
+from sqlalchemy.orm import relationship
+from sqlalchemy.sql import func
+from app.database import Base
+
+
+class MerchProduct(Base):
+    """Merch Product - Store products."""
+
+    __tablename__ = "merch_products"
+
+    id = Column(String(36), primary_key=True, index=True)
+    name = Column(String(255), nullable=False, index=True)
+    description = Column(Text, nullable=True)
+    price = Column(Float, nullable=False)
+    stock_count = Column(Integer, default=0)
+    image_url = Column(String(500), nullable=True)
+    created_at = Column(DateTime, server_default=func.now())
+    updated_at = Column(DateTime, server_default=func.now(), onupdate=func.now())
+
+    # Relationships
+    order_items = relationship("OrderItem", back_populates="product", cascade="all, delete-orphan")
+
+
+class Order(Base):
+    """Order - Purchase orders."""
+
+    __tablename__ = "orders"
+
+    id = Column(String(36), primary_key=True, index=True)
+    user_id = Column(String(36), ForeignKey("users.id"), index=True, nullable=False)
+    total = Column(Float, nullable=False)
+    status = Column(String(50), default="pending", index=True)  # pending, completed, cancelled
+    shipping_address = Column(String(500), nullable=True)  # PII - Encrypted
+    created_at = Column(DateTime, server_default=func.now(), index=True)
+    updated_at = Column(DateTime, server_default=func.now(), onupdate=func.now())
+
+    # Relationships
+    user = relationship("User", back_populates="orders")
+    items = relationship("OrderItem", back_populates="order", cascade="all, delete-orphan")
+
+
+class OrderItem(Base):
+    """Order Item - Individual items in an order."""
+
+    __tablename__ = "order_items"
+
+    id = Column(String(36), primary_key=True, index=True)
+    order_id = Column(String(36), ForeignKey("orders.id"), index=True, nullable=False)
+    product_id = Column(String(36), ForeignKey("merch_products.id"), index=True, nullable=False)
+    quantity = Column(Integer, default=1)
+    price = Column(Float, nullable=False)
+    created_at = Column(DateTime, server_default=func.now())
+
+    # Relationships
+    order = relationship("Order", back_populates="items")
+    product = relationship("MerchProduct", back_populates="order_items")
diff --git a/backend/app/models/podcast.py b/backend/app/models/podcast.py
new file mode 100644
index 0000000..389d1fe
--- /dev/null
+++ b/backend/app/models/podcast.py
@@ -0,0 +1,25 @@
+"""
+Podcast MVP model - PodcastEpisode.
+
+Job ID: MTAD-IMPL-2025-11-18-CL
+"""
+
+from sqlalchemy import Column, String, Text, Integer, DateTime
+from sqlalchemy.sql import func
+from app.database import Base
+
+
+class PodcastEpisode(Base):
+    """Podcast Episode - Audio content episodes."""
+
+    __tablename__ = "podcast_episodes"
+
+    id = Column(String(36), primary_key=True, index=True)
+    title = Column(String(500), nullable=False, index=True)
+    description = Column(Text, nullable=True)
+    audio_url = Column(String(500), nullable=False)
+    duration = Column(Integer, nullable=True)  # Duration in seconds
+    episode_number = Column(Integer, nullable=True, index=True)
+    published_at = Column(DateTime, nullable=True, index=True)
+    created_at = Column(DateTime, server_default=func.now(), index=True)
+    updated_at = Column(DateTime, server_default=func.now(), onupdate=func.now())
diff --git a/backend/app/models/resources.py b/backend/app/models/resources.py
new file mode 100644
index 0000000..7426cd8
--- /dev/null
+++ b/backend/app/models/resources.py
@@ -0,0 +1,29 @@
+"""
+Resources MVP model - Resource knowledge base.
+
+Job ID: MTAD-IMPL-2025-11-18-CL
+"""
+
+from sqlalchemy import Column, String, Text, DateTime, ForeignKey, JSON
+from sqlalchemy.orm import relationship
+from sqlalchemy.sql import func
+from app.database import Base
+
+
+class Resource(Base):
+    """Resource - Knowledge base and documentation."""
+
+    __tablename__ = "resources"
+
+    id = Column(String(36), primary_key=True, index=True)
+    author_id = Column(String(36), ForeignKey("users.id"), index=True, nullable=True)
+    title = Column(String(500), nullable=False, index=True)
+    slug = Column(String(500), unique=True, index=True, nullable=False)
+    content = Column(Text, nullable=False)
+    access_tier = Column(String(20), default="public", index=True)  # public, members
+    tags = Column(JSON, default=[], index=False)  # Array of tags
+    created_at = Column(DateTime, server_default=func.now(), index=True)
+    updated_at = Column(DateTime, server_default=func.now(), onupdate=func.now(), index=True)
+
+    # Relationships
+    author = relationship("User", back_populates="resources")
diff --git a/backend/app/models/tribute.py b/backend/app/models/tribute.py
new file mode 100644
index 0000000..8a2f853
--- /dev/null
+++ b/backend/app/models/tribute.py
@@ -0,0 +1,27 @@
+"""
+Tribute MVP model - TributeEntry for memorials.
+
+Job ID: MTAD-IMPL-2025-11-18-CL
+"""
+
+from sqlalchemy import Column, String, Text, Boolean, DateTime, ForeignKey
+from sqlalchemy.orm import relationship
+from sqlalchemy.sql import func
+from app.database import Base
+
+
+class TributeEntry(Base):
+    """Tribute Entry - Memorial and tribute entries."""
+
+    __tablename__ = "tribute_entries"
+
+    id = Column(String(36), primary_key=True, index=True)
+    author_id = Column(String(36), ForeignKey("users.id"), index=True, nullable=False)
+    subject_name = Column(String(255), nullable=False, index=True)
+    memorial_text = Column(Text, nullable=False)  # May contain PHI
+    published = Column(Boolean, default=False, index=True)
+    created_at = Column(DateTime, server_default=func.now(), index=True)
+    updated_at = Column(DateTime, server_default=func.now(), onupdate=func.now())
+
+    # Relationships
+    author = relationship("User", back_populates="tribute_entries")
diff --git a/backend/app/models/user.py b/backend/app/models/user.py
new file mode 100644
index 0000000..61a2297
--- /dev/null
+++ b/backend/app/models/user.py
@@ -0,0 +1,119 @@
+"""
+User, Profile, Role, and Consent models.
+
+Job ID: MTAD-IMPL-2025-11-18-CL
+"""
+
+from sqlalchemy import Column, String, Boolean, DateTime, Integer, ForeignKey, Text, JSON
+from sqlalchemy.orm import relationship
+from sqlalchemy.sql import func
+from app.database import Base
+from datetime import datetime
+
+
+class User(Base):
+    """User entity - Core authentication and identity."""
+
+    __tablename__ = "users"
+
+    id = Column(String(36), primary_key=True, index=True)
+    email = Column(String(255), unique=True, index=True, nullable=False)
+    password_hash = Column(String(255), nullable=False)
+    email_verified = Column(Boolean, default=False)
+    mfa_enabled = Column(Boolean, default=False)
+    mfa_secret = Column(String(255), nullable=True)  # Encrypted
+    locked_until = Column(DateTime, nullable=True)
+    failed_login_attempts = Column(Integer, default=0)
+    created_at = Column(DateTime, server_default=func.now())
+    updated_at = Column(DateTime, server_default=func.now(), onupdate=func.now())
+    deleted_at = Column(DateTime, nullable=True)
+
+    # Relationships
+    profile = relationship("Profile", back_populates="user", uselist=False, cascade="all, delete-orphan")
+    roles = relationship("UserRole", back_populates="user", cascade="all, delete-orphan")
+    consents = relationship("Consent", back_populates="user", cascade="all, delete-orphan")
+    refresh_tokens = relationship("RefreshToken", back_populates="user", cascade="all, delete-orphan")
+    audit_logs = relationship("AuthAuditLog", back_populates="user", cascade="all, delete-orphan")
+
+    # Forum relationships
+    forum_threads = relationship("ForumThread", back_populates="author")
+    forum_posts = relationship("ForumPost", back_populates="author")
+    forum_reactions = relationship("ForumReaction", back_populates="user")
+    forum_reports = relationship("ForumReport", back_populates="reporter")
+
+    # Content relationships
+    blog_posts = relationship("BlogPost", back_populates="author")
+    resources = relationship("Resource", back_populates="author")
+    tribute_entries = relationship("TributeEntry", back_populates="author")
+
+    # Commerce relationships
+    orders = relationship("Order", back_populates="user", cascade="all, delete-orphan")
+
+
+class Profile(Base):
+    """User Profile - Extended user information and health journey."""
+
+    __tablename__ = "profiles"
+
+    id = Column(String(36), primary_key=True, index=True)
+    user_id = Column(String(36), ForeignKey("users.id"), unique=True, nullable=False, index=True)
+    display_name = Column(String(255), nullable=False)
+    pseudonym = Column(String(255), nullable=True, index=True)
+    pronouns = Column(String(50), nullable=True)
+    avatar_url = Column(String(500), nullable=True)
+    bio = Column(Text, nullable=True)
+    health_journey = Column(Text, nullable=True)  # PHI - Encrypted at rest
+    consent_flags = Column(JSON, default={})
+    created_at = Column(DateTime, server_default=func.now())
+    updated_at = Column(DateTime, server_default=func.now(), onupdate=func.now())
+
+    # Relationships
+    user = relationship("User", back_populates="profile")
+
+
+class Role(Base):
+    """Role entity - RBAC roles."""
+
+    __tablename__ = "roles"
+
+    id = Column(String(36), primary_key=True, index=True)
+    name = Column(String(100), unique=True, index=True, nullable=False)
+    permissions = Column(JSON, default={})
+    created_at = Column(DateTime, server_default=func.now())
+    updated_at = Column(DateTime, server_default=func.now(), onupdate=func.now())
+
+    # Relationships
+    users = relationship("UserRole", back_populates="role", cascade="all, delete-orphan")
+
+
+class UserRole(Base):
+    """User-Role mapping for RBAC."""
+
+    __tablename__ = "user_roles"
+
+    id = Column(String(36), primary_key=True, index=True)
+    user_id = Column(String(36), ForeignKey("users.id"), index=True, nullable=False)
+    role_id = Column(String(36), ForeignKey("roles.id"), index=True, nullable=False)
+    created_at = Column(DateTime, server_default=func.now())
+
+    # Relationships
+    user = relationship("User", back_populates="roles")
+    role = relationship("Role", back_populates="users")
+
+
+class Consent(Base):
+    """Consent entity - User consent tracking for compliance."""
+
+    __tablename__ = "consents"
+
+    id = Column(String(36), primary_key=True, index=True)
+    user_id = Column(String(36), ForeignKey("users.id"), index=True, nullable=False)
+    consent_type = Column(String(100), nullable=False)  # e.g., marketing, analytics, data_sharing
+    granted = Column(Boolean, default=False)
+    granted_at = Column(DateTime, nullable=True)
+    revoked_at = Column(DateTime, nullable=True)
+    created_at = Column(DateTime, server_default=func.now())
+    updated_at = Column(DateTime, server_default=func.now(), onupdate=func.now())
+
+    # Relationships
+    user = relationship("User", back_populates="consents")
diff --git a/backend/docker-compose.yml b/backend/docker-compose.yml
new file mode 100644
index 0000000..44d9efd
--- /dev/null
+++ b/backend/docker-compose.yml
@@ -0,0 +1,86 @@
+version: '3.8'
+
+# Job ID: MTAD-IMPL-2025-11-18-CL
+# Deployment: nexus-vector (production)
+# Spec: openspec/specs/architecture.md
+
+services:
+  postgres:
+    image: postgres:15-alpine
+    container_name: mtad-postgres
+    restart: unless-stopped
+    environment:
+      POSTGRES_USER: admin
+      POSTGRES_PASSWORD: ${DB_PASSWORD:-change-me-in-production}
+      POSTGRES_DB: morethanadiagnosis
+      POSTGRES_INITDB_ARGS: "-c shared_preload_libraries=pg_stat_statements"
+    volumes:
+      - postgres_data:/var/lib/postgresql/data
+    ports:
+      - "5432:5432"
+    networks:
+      - mtad-network
+    healthcheck:
+      test: ["CMD-SHELL", "pg_isready -U admin -d morethanadiagnosis"]
+      interval: 10s
+      timeout: 5s
+      retries: 5
+
+  redis:
+    image: redis:7-alpine
+    container_name: mtad-redis
+    restart: unless-stopped
+    ports:
+      - "6379:6379"
+    volumes:
+      - redis_data:/data
+    networks:
+      - mtad-network
+    command: redis-server --appendonly yes --requirepass ${REDIS_PASSWORD:-change-me-in-production}
+    healthcheck:
+      test: ["CMD", "redis-cli", "ping"]
+      interval: 10s
+      timeout: 5s
+      retries: 5
+
+  api:
+    build:
+      context: .
+      dockerfile: Dockerfile
+    container_name: mtad-api
+    restart: unless-stopped
+    environment:
+      ENV: production
+      DEBUG: "false"
+      DATABASE_URL: postgresql://admin:${DB_PASSWORD:-change-me-in-production}@postgres:5432/morethanadiagnosis
+      REDIS_URL: redis://:${REDIS_PASSWORD:-change-me-in-production}@redis:6379/0
+      SECRET_KEY: ${SECRET_KEY:-change-me-in-production}
+      CORS_ORIGINS: '["https://morethanadiagnosis.com", "http://localhost:3000"]'
+      LOG_LEVEL: INFO
+    ports:
+      - "8000:8000"
+    depends_on:
+      postgres:
+        condition: service_healthy
+      redis:
+        condition: service_healthy
+    networks:
+      - mtad-network
+    volumes:
+      - ./app:/app/app:ro
+    healthcheck:
+      test: ["CMD", "curl", "-f", "http://localhost:8000/health"]
+      interval: 30s
+      timeout: 10s
+      retries: 3
+      start_period: 10s
+
+networks:
+  mtad-network:
+    driver: bridge
+
+volumes:
+  postgres_data:
+    driver: local
+  redis_data:
+    driver: local
diff --git a/backend/requirements.txt b/backend/requirements.txt
new file mode 100644
index 0000000..933620b
--- /dev/null
+++ b/backend/requirements.txt
@@ -0,0 +1,66 @@
+# Core Framework
+fastapi==0.104.1
+uvicorn[standard]==0.24.0
+pydantic==2.5.0
+pydantic-settings==2.1.0
+python-multipart==0.0.6
+
+# Database
+sqlalchemy==2.0.23
+alembic==1.12.1
+psycopg2-binary==2.9.9
+psycopg[binary]==3.9.10
+
+# Authentication & Security
+passlib[bcrypt]==1.7.4
+python-jose[cryptography]==3.3.0
+PyJWT==2.8.1
+bcrypt==4.1.1
+cryptography==41.0.7
+argon2-cffi==23.1.0
+
+# API Documentation
+python-dateutil==2.8.2
+
+# Validation & Serialization
+email-validator==2.1.0
+
+# Environment Variables
+python-dotenv==1.0.0
+
+# Logging & Observability
+python-json-logger==2.0.7
+opentelemetry-api==1.21.0
+opentelemetry-sdk==1.21.0
+opentelemetry-exporter-jaeger==1.21.0
+opentelemetry-instrumentation-fastapi==0.42b0
+opentelemetry-instrumentation-sqlalchemy==0.42b0
+
+# Data Validation & Transformation
+marshmallow==3.20.1
+
+# Testing
+pytest==7.4.3
+pytest-asyncio==0.21.1
+pytest-cov==4.1.0
+httpx==0.25.2
+
+# Linting & Type Checking
+ruff==0.1.8
+mypy==1.7.1
+types-python-dateutil==2.8.20
+
+# Development
+black==23.12.0
+isort==5.13.2
+pre-commit==3.5.0
+
+# CORS & Middleware
+fastapi-cors==0.0.6
+
+# Rate Limiting
+slowapi==0.1.9
+
+# Background Tasks
+celery==5.3.4
+redis==5.0.1