HOLLIDAYSBURG, Pa. — Luigi Mangione, a member of a well-known family in the Baltimore area, on Thursday waived extradition from Pennsylvania to New York to face charges in the deadly shooting of UnitedHealthcare CEO Brian Thompson outside a hotel in Midtown Manhattan.

The procedural legal step cleared the way for the New York Police Department to take him into custody. He’s charged in New York State Supreme Court with 11 counts including first-degree murder in the killing, which happened on Dec. 4 outside the New York Hilton Midtown.

If he’s convicted, Mangione faces life in prison without the possibility of parole.

“These things are something we do all the time in our office,” Blair County District Attorney Peter Weeks told reporters at a news conference after the hearing. “They just don’t normally get attention — and certainly not this level of attention.”

Mangione, 26, had been held in the State Correctional Institution at Huntingdon without bail since police in Altoona, Pennsylvania, arrested him last week at a McDonald’s on charges of forgery, carrying a firearm without a license, possessing instruments of a crime and related offenses.

Police allege they searched his backpack and found a 3D-printed gun and silencer along with a magazine containing six 9 mm cartridges and one loose round.

Officers claim they also found a notebook that included plans for the fatal shooting, and one passage that read, “What do you do? You wack the C.E.O. at the annual parasitic bean-counter convention. It’s targeted, precise, and doesn’t risk innocents.”

At first, Mangione challenged his extradition. As sheriff’s deputies escorted him last week into the Blair County Courthouse, he shouted at reporters, “That’s completely out of touch, and an insult to the intelligence of the American people and to lived experience!”

During the court proceedings on Thursday, Mangione wore an ill-fitting orange prison jumpsuit with a maroon shirt underneath. He conferred with his attorney, occasionally flashing a smile and peering at reporters and police officers who filled the courtroom. He swiveled in a chair and read court documents.

Three Blair County sheriff’s deputies stood around him in a semicircle. Meanwhile, at least a dozen NYPD officers — along with a photographer — sat mostly expressionless in the first row of the courtroom gallery.

First, Mangione waived his right to a preliminary hearing after prosecutors agreed to immediately turn over a 20-page report from the Altoona Police Department. Then, after a 45-minute conference in chambers, he waived extradition.

“Up until this time, we had been fighting extradition,” said Tom Dickey, Mangione’s attorney. “At this time, things have changed.”

He noted that his client had since obtained counsel in New York. Dickey said he was satisfied that there will be a “smooth transition,” adding that “we now believe it’s in my client’s best interest to do so.”

Blair County Common Pleas Judge David B. Consiglio advised Mangione about his rights.

“Do you understand, sir?” Consiglio asked.

“Yes,” Mangione replied.

Between the two hearings, Mangione uttered a total of five words.

Mangione graduated from the Gilman School, a private, independent all-boys school in Roland Park, in 2016 as valedictorian. He went on to earn his bachelor’s and master’s degree in computer science in 2020 from the University of Pennsylvania.

At one point, Mangione moved to Honolulu, Hawaii, where he worked as a data engineer.

But earlier this year, Mangione disengaged. His mother filed a missing person report. Friends pleaded with him to return their messages.

A picture on his profile on X, formerly known as Twitter, shows a picture of an X-ray of a spine with four large screws in it. He spoke about pain, his friends said, stemming from long-running back problems.

Online, Mangione left a large footprint. He engaged in debates about philosophy, posed on hikes and reviewed a book by Ted Kaczynski, a domestic terrorist known as the “Unabomber.”

Thompson became CEO of UnitedHealthcare in 2021. His wife, Paulette, described him as an “incredibly loving, generous, talented man” and a “loving father to our two sons.” He was 50.

Manhattan District Attorney Alvin Bragg said Mangione committed the crime to evoke terror. Those acts are defined under state law.

“This was a frightening, well-planned, targeted murder that was intended to cause shock and attention and intimidation,” Bragg told reporters earlier this week at a news conference.

Since his arrest, Mangione has become a folk hero for some anti-capitalists and people frustrated with the U.S. health care system. Several supporters even stood outside the courthouse holding signs and wearing the hat of the character Luigi from the Nintendo video game franchise “Mario.”

Those including New York Police Commissioner Jessica Tisch have slammed what she described as a “shocking and appalling celebration of cold-blooded murder.”

Tisch called the fatal shooting a “cold and calculated crime that stole a life and put New Yorkers at risk.”

“We don’t celebrate murders,” Tisch said, “and we don’t lionize the killing of anyone.”