Background: Patient satisfaction is a key indicator for improving healthcare delivery, yet the influence of gender preferences on healthcare providers remains underexplored. Cultural norms and gender perceptions often shape the patient preferences, affecting access to care, patient–provider relationships, and overall satisfaction. Thus, this study investigates the patients' gender preferences and their impact on satisfaction in Tanzania. Methods: The study utilized a cross-sectional design, collecting data from five health centres: Mikongeni, Konga, Mzumbe, Tangeni, and Mlali. A total of 240 randomly selected respondents participated in the study. Gender preferences were categorized as male, female, and both, and determinants were analyzed using a multivariate probit model (MPM), while satisfaction was analyzed using an ordered logit model (OLM). Results: Results reveal that female providers were preferred for empathy (58.30%), intimate care (50.00%), and receptionist roles (50.00%), while males were favored for surgery (50.00%), professionalism (0.86), and IT roles (41.70%). Professionalism (0.75) and communication (0.70) had the strongest positive effects on very high satisfaction. Male provider preference was strongly linked to higher satisfaction (0.84), while female preference showed a mild effect (0.23). Insurance (0.32) and care at Tangeni Health Centre (0.70) boosted satisfaction, while consultation fees (−0.26) reduced it. Conclusions: The study recommends that healthcare systems address gender stereotypes by equipping all providers with both technical and relational care skills, regardless of gender. It also highlights the need for culturally and religiously sensitive care practices that acknowledge how societal norms shape patient preferences and satisfaction. To enhance patient-centered care, policies should promote affordability, broaden insurance coverage, and integrate patient feedback on gender preferences into healthcare delivery models.