diff --git a/src/commands/doctor-config-flow.missing-default-account-bindings.integration.test.ts b/src/commands/doctor-config-flow.missing-default-account-bindings.integration.test.ts
index a5e0be54d97..bbfe3063b23 100644
--- a/src/commands/doctor-config-flow.missing-default-account-bindings.integration.test.ts
+++ b/src/commands/doctor-config-flow.missing-default-account-bindings.integration.test.ts
@@ -1,4 +1,4 @@
-import { describe, expect, it, vi } from "vitest";
+import { beforeEach, describe, expect, it, vi } from "vitest";
 import { note } from "../terminal/note.js";
 import { withEnvAsync } from "../test-utils/env.js";
 import { runDoctorConfigWithInput } from "./doctor-config-flow.test-utils.js";
@@ -23,6 +23,10 @@ import { loadAndMaybeMigrateDoctorConfig } from "./doctor-config-flow.js";
 const noteSpy = vi.mocked(note);
 
 describe("doctor missing default account binding warning", () => {
+  beforeEach(() => {
+    noteSpy.mockClear();
+  });
+
   it("emits a doctor warning when named accounts have no valid account-scoped bindings", async () => {
     await withEnvAsync(
       {
@@ -83,4 +87,36 @@ describe("doctor missing default account binding warning", () => {
       "Doctor warnings",
     );
   });
+
+  it("emits a warning when defaultAccount does not match configured accounts", async () => {
+    await withEnvAsync(
+      {
+        TELEGRAM_BOT_TOKEN: undefined,
+        TELEGRAM_BOT_TOKEN_FILE: undefined,
+      },
+      async () => {
+        await runDoctorConfigWithInput({
+          config: {
+            channels: {
+              telegram: {
+                defaultAccount: "missing",
+                accounts: {
+                  alerts: {},
+                  work: {},
+                },
+              },
+            },
+          },
+          run: loadAndMaybeMigrateDoctorConfig,
+        });
+      },
+    );
+
+    expect(noteSpy).toHaveBeenCalledWith(
+      expect.stringContaining(
+        'channels.telegram: defaultAccount is set to "missing" but does not match configured accounts',
+      ),
+      "Doctor warnings",
+    );
+  });
 });