Riparian ecosystems fundamentally depend on groundwater, especially in dryland regions, yet their water requirements and sources are rarely considered in water resource management decisions. Until recently, technological limitations and data gaps have hindered assessment of groundwater influences on riparian ecosystem health at the spatial and temporal scales relevant to policy and management. Here, we analyze Sentinel-2-derived normalized difference vegetation index (NDVI; n = 5,335,472 observations), field-based groundwater elevation (n = 32,051 observations), and streamflow alteration data for riparian woodland communities (n = 22,153 polygons) over a 5-y period (2015 to 2020) across California. We find that riparian woodlands exhibit a stress response to deeper groundwater, as evidenced by concurrent declines in greenness represented by NDVI. Furthermore, we find greater seasonal coupling of canopy greenness to groundwater for vegetation along streams with natural flow regimes in comparison with anthropogenically altered streams, particularly in the most water-limited regions. These patterns suggest that many riparian woodlands in California are subsidized by water management practices. Riparian woodland communities rely on naturally variable groundwater and streamflow components to sustain key ecological processes, such as recruitment and succession. Altered flow regimes, which stabilize streamflow throughout the year and artificially enhance water supplies to riparian vegetation in the dry season, disrupt the seasonal cycles of abiotic drivers to which these Mediterranean forests are adapted. Consequently, our analysis suggests that many riparian ecosystems have become reliant on anthropogenically altered flow regimes, making them more vulnerable and less resilient to rapid hydrologic change, potentially leading to future riparian forest loss across increasingly stressed dryland regions.