X0202 SCHEDULE 13D/A 0001871714 XXXXXXXX LIVE 1 Common Stock, $0.0001 par value per share 07/31/2026 false 0000034956 88032L605 Tenax Therapeutics, Inc.

101 Glen Lennox Drive, Suite 300 Chapel Hill NC 27517

Christopher Thomas Giordano 919-855-2100 c/o Tenax Therapeutics, Inc. 101 Glen Lennox Drive, Suite 300 Chapel Hill NC 27517 0001871714 N Christopher Thomas Giordano OO N X1 1690606 0 1690606 0 1690606 N 4.32 IN The percentage reported above is based on 37,423,917 shares of Common Stock outstanding as of July 28, 2026, as reported in the Issuer's Form 10-Q filed with the SEC on July 31, 2026 and is calculated on a beneficial ownership basis. Common Stock, $0.0001 par value per share Tenax Therapeutics, Inc. 101 Glen Lennox Drive, Suite 300 Chapel Hill NC 27517 This Amendment No. 1 to Schedule 13D ("Schedule 13D/A"), which amends the statement on Schedule 13D filed with the SEC on March 10, 2026, is filed by Mr. Giordano (the "Reporting Person"). Except as expressly amended below, the Schedule 13D remains in effect. Capitalized terms used but not defined in this Schedule 13D/A shall have the meanings set forth in the Schedule 13D. This Schedule 13D/A is filed solely as a result of the increase in the number of issued and outstanding shares of the Issuer's Common Stock. As of the date of this filing, the Reporting Person is deemed to own in the aggregate and on a beneficial ownership basis, 11,324 shares of Common Stock and 1,679,282 shares of Common Stock underlying stock options comprised of (i) 1,241,500 shares of Common Stock underlying options with an exercise price of $5.94 per share, (ii) 437,500 shares of Common Stock underlying options with an exercise price of $5.89 per share, (iii) 125 shares of Common Stock underlying options with an exercise price of $992 per share, and (iv) 157 shares of Common Stock underlying options with an exercise price of $3,152 per share. The filing of this Amendment No. 1 represents the final amendment to this Schedule 13D and constitutes an exit filing for the Reporting Person. The Reporting Person reports his beneficial ownership in accordance with the filing requirements of Section 16(a) of the Act. 1,690,606 - 4.32% 1,690,606 Christopher Thomas Giordano /s/ Christopher Thomas Giordano 07/31/2026