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Malcolm MacKenzie has a wealth of experience in the business world. Malcolm began their career as a consultant at the Boston Consulting Group (BCG) in 1986, and then again in 1999. In 1988, they became a serial entrepreneur, founding and acting as CEO for For Nurses Only, America By Mail, and Arcama Recycling. In 1995, they were a consultant at Monitor Consulting. From 2000 to 2012, they were the CEO and co-founder of Quosa, Inc., a software company focused on workflows related to bio-medical literature and information. In 2013, they co-founded ActivSignal.

Malcolm MacKenzie obtained their Bachelor of Arts in Economics from the University of Toronto - University of Trinity College between 1974 and 1979. Malcolm then went on to pursue a Master of Business Administration from Stanford University Graduate School of Business between 1984 and 1986.