Within the west-central Sierra Nevada, archaeologists have long debated the effects of the Medieval Climate Anomaly (MCA) on the indigenous culture, owing largely to the scant archaeological evidence produced during this period. More broadly, climate events are frequently included within arguments surrounding the reorganization of culture or their inexplicable decline. Within this region, the argument leans towards the former, however, this has led to further questions regarding the nature of this cultural reorganization. The previous cultural pattern of greater residential-than-logistical mobility, and a greater reliance on pine nuts than acorns as a storable staple seems to end around the same time as the droughts start. This dissertation examines the relationships among diet, mobility, and drought in the west-central Sierra Nevada over the last ~4000 years. It asks two related questions: how settlement structure, residential mobility, diet, and climate articulated through time, and how indigenous communities adapted to short- and long-term climatic shifts, especially drought. While human behavioral ecology theory guides the main hypothesis that water, if treated as a resource patch, was a limiting resource during the MCA, I used stable isotope analysis of paleobotanical, faunal, and human remains within a diachronic framework, together with regional archaeological and environmental evidence to address these questions. The paleobotanical analysis established a local isotopic baseline and demonstrated meaningful differences between angiosperm and gymnosperm resources, allowing the long-term importance of pine nuts to human diets to be more directly evaluated. The faunal analysis established baseline expectations for animal protein and local sulfur isotope ranges and further explored paleoprecipitation estimation from collagen. These lines of evidence were integrated with human carbon, nitrogen, and sulfur isotope data to evaluate dietary change, residential mobility, and the possibility of non-local movement through time. The results indicate that substantial social reorganization occurred during the Recent Prehistoric I period (RP I; 1100-610 cal BP), coeval with the MCA droughts. Dietary change was not instantaneous, but the shift toward greater use of angiosperms, and reduced reliance on gymnosperm resources was fully manifest by RP I. Sulfur isotope analysis suggests reduced residential mobility during this interval and does not support a simple replacement model, though some non-local individuals were present. Paleoprecipitation estimates derived from plants, fauna, and humans further suggest that drought-related environmental stress formed an important part of this sequence. Taken together, the evidence supports an interpretation in which drought acted as a catalyst for the initial reorganization of settlement, mobility, and diet, while later territoriality likely helped maintain reduced residential mobility into the Recent Prehistoric II period (RP II; 610-100 cal BP).