A regional endemic known from the central Appalachians of western Virginia, eastern West Virginia, western Maryland, and southern Pennsylvania, as well as from the Interior Low Plateau of central Kentucky, southern Ohio, and central Tennessee; a few occurrences are also known from the intervening Cumberlands/Southern Ridge and Valley region. Approximately 67 occurrences are believed extant, mostly in West Virginia, Virginia, and Kentucky. The number of genetic individuals may be very low, as a single genotype can comprise much or all of the occupied area at some sites. Euonymus scale (Unaspis euonymi) is a major threat in Kentucky , with more than 80% of occurrences found to be drastically declining in a recent statewide survey. The magnitude of this threat elsewhere in the range is as-yet undetermined; the scale is also known to occur in at least Virginia as well, although it has not yet been observed in other parts of the range such as Ohio. P. canbyi may also be declining (possibly severely) in West Virginia, presumably due to deer browsing. The species is protected from many other threats by the nature of its habitat; other minor impacts include quarrying, fires, indirect erosional impacts from nearby clearcutting, trampling, collecting, and grazing.
Threats include disturbance to cliff and slope habitats, trampling, rock climbing and soil compaction. Paxistima canybi can become uncommon as a forest canopy matures because it does not compete well in shaded habitat.
Current population sites and sizes are unknown.
Reintroduction methods and potential need to be explored.
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