diff --git a/src/monai_physio/segment_chest_total_segmentator.py b/src/monai_physio/segment_chest_total_segmentator.py
index ab78ec0..e591548 100644
--- a/src/monai_physio/segment_chest_total_segmentator.py
+++ b/src/monai_physio/segment_chest_total_segmentator.py
@@ -321,8 +321,14 @@ def segmentation_method(self, preprocessed_image: itk.image) -> itk.image:
             >>> labelmap = segmenter.segmentation_method(preprocessed_ct)
         """
         with tempfile.TemporaryDirectory() as tmp_dir:
+            from totalsegmentator.config import set_config_key, setup_totalseg
             from totalsegmentator.python_api import totalsegmentator
 
+            # Ensure config folder/file exist, then disable telemetry.
+            setup_totalseg()
+            set_config_key("send_usage_stats", False)
+            set_config_key("statistics_disclaimer_shown", True)
+
             # ITK and Nibabel use different coordinate systems (LPS vs RAS).
             # The safest conversion is via a temporary file. This approach
             # still reduces I/O compared to the original implementation.