diff --git a/crates/ty/docs/rules.md b/crates/ty/docs/rules.md
index 5a3f80c9e6fec1..35bfee13b96432 100644
--- a/crates/ty/docs/rules.md
+++ b/crates/ty/docs/rules.md
@@ -3489,7 +3489,7 @@ the variable they are assigned to.
 
 
 Constructors like `TypeVar`, `ParamSpec`, `NewType`, `NamedTuple`,
-`TypedDict`, and `TypeAliasType` all take a name argument that is
+`TypedDict`, `TypeAliasType`, and `Sentinel` all take a name argument that is
 normally expected to match the assigned variable. A mismatch is usually a
 typo and makes later diagnostics harder to understand.
 
@@ -3504,12 +3504,13 @@ continue understanding the resulting type.
 
 ```python
 from typing import NewType, ParamSpec, TypeVar
-from typing_extensions import TypedDict
+from typing_extensions import Sentinel, TypedDict
 
 T = TypeVar("U")  # error: [mismatched-type-name]
 P = ParamSpec("Q")  # error: [mismatched-type-name]
 UserId = NewType("Id", int)  # error: [mismatched-type-name]
 Movie = TypedDict("Film", {"title": str})  # error: [mismatched-type-name]
+Missing = Sentinel("NotGiven")  # error: [mismatched-type-name]
 ```
 
 ## `missing-argument`
diff --git a/crates/ty_python_semantic/resources/lint_docs/mismatched-type-name.md b/crates/ty_python_semantic/resources/lint_docs/mismatched-type-name.md
index 3bdd62559cac42..4ae384fd92381c 100644
--- a/crates/ty_python_semantic/resources/lint_docs/mismatched-type-name.md
+++ b/crates/ty_python_semantic/resources/lint_docs/mismatched-type-name.md
@@ -6,7 +6,7 @@ the variable they are assigned to.
 ## Why is this bad?
 
 Constructors like `TypeVar`, `ParamSpec`, `NewType`, `NamedTuple`,
-`TypedDict`, and `TypeAliasType` all take a name argument that is
+`TypedDict`, `TypeAliasType`, and `Sentinel` all take a name argument that is
 normally expected to match the assigned variable. A mismatch is usually a
 typo and makes later diagnostics harder to understand.
 
@@ -19,10 +19,11 @@ continue understanding the resulting type.
 
 ```python
 from typing import NewType, ParamSpec, TypeVar
-from typing_extensions import TypedDict
+from typing_extensions import Sentinel, TypedDict
 
 T = TypeVar("U")  # error: [mismatched-type-name]
 P = ParamSpec("Q")  # error: [mismatched-type-name]
 UserId = NewType("Id", int)  # error: [mismatched-type-name]
 Movie = TypedDict("Film", {"title": str})  # error: [mismatched-type-name]
+Missing = Sentinel("NotGiven")  # error: [mismatched-type-name]
 ```
diff --git a/crates/ty_python_semantic/resources/mdtest/sentinels.md b/crates/ty_python_semantic/resources/mdtest/sentinels.md
index fe54fb8b50a9b9..e4c8657dd841fb 100644
--- a/crates/ty_python_semantic/resources/mdtest/sentinels.md
+++ b/crates/ty_python_semantic/resources/mdtest/sentinels.md
@@ -70,6 +70,18 @@ def reverse_negative_check(x: int | MISSING | OTHER) -> None:
         reveal_type(x)  # revealed: MISSING
 ```
 
+Sentinel names must match their assigned variables, including when the constructor has an alias or
+an explicit representation:
+
+```py
+from typing_extensions import Sentinel as SentinelAlias
+
+MISMATCHED = Sentinel("OTHER")  # error: [mismatched-type-name]
+MISMATCHED_WITH_POSITIONAL_REPR = Sentinel("OTHER", "other")  # error: [mismatched-type-name]
+MISMATCHED_WITH_KEYWORD_REPR = Sentinel("OTHER", repr="other")  # error: [mismatched-type-name]
+ALIASED_MISMATCHED = SentinelAlias("OTHER")  # error: [mismatched-type-name]
+```
+
 Sentinel objects are always truthy, expose the standard sentinel metadata attributes, and are
 rejected as class bases:
 
@@ -88,6 +100,16 @@ Sentinels declared in class scope can also be used in type expressions:
 ```py
 class C:
     MARKER = Sentinel("C.MARKER")
+    UNQUALIFIED = Sentinel("UNQUALIFIED")
+    WRONG_CLASS = Sentinel("Other.WRONG_CLASS")  # error: [mismatched-type-name]
+    WRONG_NAME = Sentinel("C.OTHER")  # error: [mismatched-type-name]
+
+    class Nested:
+        MARKER = Sentinel("C.Nested.MARKER")
+        UNQUALIFIED = Sentinel("UNQUALIFIED")
+        PARTIALLY_QUALIFIED = Sentinel("Nested.PARTIALLY_QUALIFIED")  # error: [mismatched-type-name]
+        WRONG_CLASS = Sentinel("Other.Nested.WRONG_CLASS")  # error: [mismatched-type-name]
+        WRONG_NAME = Sentinel("C.Nested.OTHER")  # error: [mismatched-type-name]
 
 def accepts_marker(x: C.MARKER) -> None: ...
 
@@ -210,6 +232,18 @@ def reverse_negative_check(x: int | MISSING | OTHER) -> None:
         reveal_type(x)  # revealed: MISSING
 ```
 
+Sentinel names must match their assigned variables, including when the builtin is imported under an
+alias or given an explicit representation:
+
+```py
+from builtins import sentinel as sentinel_alias
+
+MISMATCHED = sentinel("OTHER")  # error: [mismatched-type-name]
+MISMATCHED_WITH_POSITIONAL_REPR = sentinel("OTHER", "other")  # error: [mismatched-type-name]
+MISMATCHED_WITH_KEYWORD_REPR = sentinel("OTHER", repr="other")  # error: [mismatched-type-name]
+ALIASED_MISMATCHED = sentinel_alias("OTHER")  # error: [mismatched-type-name]
+```
+
 Sentinel objects are always truthy, expose the standard sentinel metadata attributes, and are
 rejected as class bases:
 
@@ -228,6 +262,16 @@ Sentinels declared in class scope can also be used in type expressions:
 ```py
 class C:
     MARKER = sentinel("C.MARKER")
+    UNQUALIFIED = sentinel("UNQUALIFIED")
+    WRONG_CLASS = sentinel("Other.WRONG_CLASS")  # error: [mismatched-type-name]
+    WRONG_NAME = sentinel("C.OTHER")  # error: [mismatched-type-name]
+
+    class Nested:
+        MARKER = sentinel("C.Nested.MARKER")
+        UNQUALIFIED = sentinel("UNQUALIFIED")
+        PARTIALLY_QUALIFIED = sentinel("Nested.PARTIALLY_QUALIFIED")  # error: [mismatched-type-name]
+        WRONG_CLASS = sentinel("Other.Nested.WRONG_CLASS")  # error: [mismatched-type-name]
+        WRONG_NAME = sentinel("C.Nested.OTHER")  # error: [mismatched-type-name]
 
 def accepts_marker(x: C.MARKER) -> None: ...
 
@@ -285,6 +329,7 @@ UNKNOWN_KEYWORD = sentinel("UNKNOWN_KEYWORD", unknown=NAME)  # error: [unknown-a
 import typing_extensions
 
 EXTENSIONS_MISSING = typing_extensions.Sentinel("EXTENSIONS_MISSING")
+EXTENSIONS_MISMATCHED = typing_extensions.Sentinel("OTHER")  # error: [mismatched-type-name]
 
 def f(x: int | EXTENSIONS_MISSING): ...
 
diff --git a/crates/ty_python_semantic/src/types/infer/builder.rs b/crates/ty_python_semantic/src/types/infer/builder.rs
index 6cccb9f29bf41c..a00ece4921b5b2 100644
--- a/crates/ty_python_semantic/src/types/infer/builder.rs
+++ b/crates/ty_python_semantic/src/types/infer/builder.rs
@@ -3479,21 +3479,61 @@ impl<'db, 'ast> TypeInferenceBuilder<'db, 'ast> {
             return None;
         }
 
-        let Some(repr_arg) = repr_arg else {
-            return Some(Type::KnownInstance(KnownInstanceType::Sentinel(
-                SentinelInstance::new(self.db(), target_name, definition),
-            )));
-        };
-
-        if !matches!(repr_arg, ast::Expr::StringLiteral(_)) && !repr_arg.is_none_literal_expr() {
+        if repr_arg.is_some_and(|repr_arg| {
+            !matches!(repr_arg, ast::Expr::StringLiteral(_)) && !repr_arg.is_none_literal_expr()
+        }) {
             return None;
         }
 
+        let name_arg_ty = self.infer_expression(name_arg, TypeContext::default());
+        let name = name_arg_ty.as_string_literal()?.value(self.db());
+
+        if !self.sentinel_name_matches_target(name, target_name) {
+            report_mismatched_type_name(
+                &self.context,
+                name_arg,
+                KnownClass::Sentinel.name(self.db()),
+                target_name,
+                Some(name),
+                name_arg_ty,
+            );
+        }
+
         Some(Type::KnownInstance(KnownInstanceType::Sentinel(
             SentinelInstance::new(self.db(), target_name, definition),
         )))
     }
 
+    /// Sentinel names can be unqualified or include their exact enclosing class path.
+    fn sentinel_name_matches_target(&self, name: &str, target_name: &Name) -> bool {
+        if name == target_name.as_str() {
+            return true;
+        }
+
+        let mut name_components = name.rsplit('.');
+
+        if name_components.next() != Some(target_name.as_str()) {
+            return false;
+        }
+
+        for (_, scope) in self
+            .index
+            .ancestor_scopes(self.scope.file_scope_id(self.db()))
+        {
+            match scope.node() {
+                NodeWithScopeKind::Class(class) => {
+                    if name_components.next() != Some(class.node(self.module()).name.as_str()) {
+                        return false;
+                    }
+                }
+                NodeWithScopeKind::Module => return name_components.next().is_none(),
+                _ => return false,
+            }
+        }
+
+        false
+    }
+
     fn sentinel_definition_scope_is_supported(&self) -> bool {
         let db = self.db();
         let mut scope_id = self.scope.file_scope_id(db);
diff --git a/ty.schema.json b/ty.schema.json
index be1fa4be1c305a..52362b1fbd17ca 100644
--- a/ty.schema.json
+++ b/ty.schema.json
@@ -1109,7 +1109,7 @@
         },
         "mismatched-type-name": {
           "title": "detects functional typing definitions whose declared name does not match the assigned variable",
-          "description": "## What it does\n\nChecks for functional typing definitions whose declared name does not match\nthe variable they are assigned to.\n\n## Why is this bad?\n\nConstructors like `TypeVar`, `ParamSpec`, `NewType`, `NamedTuple`,\n`TypedDict`, and `TypeAliasType` all take a name argument that is\nnormally expected to match the assigned variable. A mismatch is usually a\ntypo and makes later diagnostics harder to understand.\n\n## Default level\n\nThis rule is a warning by default because ty can usually recover and\ncontinue understanding the resulting type.\n\n## Examples\n\n```python\nfrom typing import NewType, ParamSpec, TypeVar\nfrom typing_extensions import TypedDict\n\nT = TypeVar(\"U\")  # error: [mismatched-type-name]\nP = ParamSpec(\"Q\")  # error: [mismatched-type-name]\nUserId = NewType(\"Id\", int)  # error: [mismatched-type-name]\nMovie = TypedDict(\"Film\", {\"title\": str})  # error: [mismatched-type-name]\n```",
+          "description": "## What it does\n\nChecks for functional typing definitions whose declared name does not match\nthe variable they are assigned to.\n\n## Why is this bad?\n\nConstructors like `TypeVar`, `ParamSpec`, `NewType`, `NamedTuple`,\n`TypedDict`, `TypeAliasType`, and `Sentinel` all take a name argument that is\nnormally expected to match the assigned variable. A mismatch is usually a\ntypo and makes later diagnostics harder to understand.\n\n## Default level\n\nThis rule is a warning by default because ty can usually recover and\ncontinue understanding the resulting type.\n\n## Examples\n\n```python\nfrom typing import NewType, ParamSpec, TypeVar\nfrom typing_extensions import Sentinel, TypedDict\n\nT = TypeVar(\"U\")  # error: [mismatched-type-name]\nP = ParamSpec(\"Q\")  # error: [mismatched-type-name]\nUserId = NewType(\"Id\", int)  # error: [mismatched-type-name]\nMovie = TypedDict(\"Film\", {\"title\": str})  # error: [mismatched-type-name]\nMissing = Sentinel(\"NotGiven\")  # error: [mismatched-type-name]\n```",
           "default": "warn",
           "oneOf": [
             {