Background <p>Healthcare workers are exposed to sustained occupational stressors that may lead to heterogeneous patterns of psychological distress and resilience, with potential implications for job satisfaction. Person-centered approaches may help identify subgroups with distinct mental health profiles.</p> Methods <p>We conducted a cross-sectional survey between December 2024 and March 2025 among healthcare workers employed in a single Italian Local Health Authority (ASL 1 Abruzzo). Participants completed measures of anxiety (GAD-7), depressive symptoms (PHQ-9), insomnia (ISI), resilience (RSA-11), perceived stress (PSS-10), and job satisfaction (JSS). K-means clustering on standardized mental health measures was used to identify profiles; the optimal number of clusters was selected using multiple internal validation indices (Gap statistic, average silhouette width, elbow method, and NbClust majority rule). Clusters were compared on sociodemographic variables and job satisfaction using non-parametric tests and chi-square tests.</p> Results <p>Of 383 respondents, five were excluded (<i>n</i> = 2 for invalid response patterns, <i>n</i> = 3 for incomplete data), yielding <i>N</i> = 378. A two-cluster solution emerged. Cluster 1 (<i>n</i> = 145) showed higher psychological distress and perceived stress and lower resilience; Cluster 2 (<i>n</i> = 233) showed lower anxiety, depressive symptoms, insomnia and perceived stress, alongside higher resilience. Job satisfaction was significantly higher in Cluster 2 than Cluster 1 (Wilcoxon W = 21521, <i>p</i> &lt; 0.001, <i>r</i> = 0.23). Cluster membership also differed by gender and work site.</p> Conclusions <p>Two distinct mental health profiles were identified within a single health authority, highlighting a subgroup characterized by high distress, low resilience and lower job satisfaction. Targeted psychosocial and organizational interventions may be warranted to support this vulnerable group and sustain workforce wellbeing.</p>