Integrated primacy care (IPC) is a model used to identify and address common pediatric primary care concerns, but limited research has focused on understanding the rates of consultation requests and patient engagement. Using retrospective electronic health record data for 970 patients served in 12 primary care sites affiliated with a pediatric hospital in the Northeast United States, our study identified consultation requests and treatment engagement across presenting problems and patient sociodemographic factors. Using descriptive statistics and logistic regressions, we found that anxiety and disruptive behavior were the most common consultation request reasons by primary care clinicians (PCCs). We also found that school age children and adolescents were more likely to receive requests for support of internalizing problems, while consultation requests for disruptive behavior and health problems were more common among early childhood patients. Consultation requests also varied by patient race/ethnicity, gender, visit type, and insurance type. Linear regression showed that treatment engagement was greater for patients with ADHD and lower for those with consultation requests for ASD/Developmental concerns. Overall, our study revealed developmental trends in consultation requests made by PCCs, and sociodemographic findings that may be related to disparities in pediatric behavioral healthcare. We highlight implications for implementation of IPC models to identify PCC knowledge gaps and support provider comfort with assessing and providing appropriate behavioral health treatment.