Land-use change represents a primary driver of carnivore population declines, yet some large carnivore species have acclimated and persist within anthropogenically altered landscapes. Previous attention has been focused on the genetic and behavioral implications of land-use changes, but few studies have investigated how human development impacts animal physiology and health. Here we examined how body condition scores of a widely distributed North American carnivore, the puma (Puma concolor), are affected by anthropogenic habitat modification. For this study we collected 252 puma camera trap events across a land-use gradient in the San Francisco Bay Area. We found that pumas in this region generally had body condition scores within a healthy range. However, pumas in areas with marginal development (e.g., parks, golf courses, low-density residences) had significantly higher body condition scores than conspecifics in areas defined as highly developed (urban) or undeveloped (wilderness). Notably, detections of black-tailed deer (Odocoileus hemionus columbianus) showed the same patterns. Additionally, puma body condition was significantly and positively correlated with detection frequency of small prey like raccoons and squirrels. Taken together, our findings show that pumas are present in developed environments, and suggest that puma body condition may reflect relative prey abundance across land-use types. We suggest that in mixed-use landscapes where public tolerance of large carnivores is sufficient, management efforts should integrate non-wilderness lands into conservation plans for pumas. However, in areas defined by low tolerance or high conflict potential, management should focus on public education and control of food resources that attract pumas to those areas.