A Japanese court on Thursday sentenced a Manhattan-based doctor to an 18-month suspended prison term after he was found guilty of vandalizing two historic religious sites in 2015. The ruling marks the conclusion of a lengthy legal process that involved the rare extradition of the defendant from the United States to Japan.

Dr. Masahide Kanayama, 63, was convicted of damaging the Naritasan Shinsho-ji Temple near Tokyo and the Katori Jingu Shrine in Chiba Prefecture by smearing an oily substance on wooden pillars and an offerings box. The temple, dating back over a millennium, and the shrine, founded in 643 B.C., both hold significant cultural and historical importance.

During the trial, Dr. Kanayama, a practicing Christian and Japanese citizen who has lived and worked in Manhattan for nearly 30 years, acknowledged his actions. He told the court that he believed he was acting under the guidance of the Holy Spirit, although he later called this a "misconception."

In delivering the verdict, Judge Yoko Sugiyama underscored the value of preserving cultural heritage and condemned the defendant for placing his religious beliefs above the law. Nonetheless, the judge suspended the prison sentence for three years, noting Dr. Kanayama’s commitment to avoid repeating the offense.

Dr. Kanayama is known for his medical expertise in endometriosis and runs a nonprofit organization focused on integrating faith into daily life and work. In previous statements, he described his surgical practice as a way to serve God by helping others, linking his medical work to his Christian faith.

The extradition request was submitted by Japan in 2016, leading to a protracted legal battle in U.S. courts before a federal judge allowed the transfer in early 2023. Dr. Kanayama was apprehended on March 4 while en route from the United States to Japan.

Japanese authorities pieced together evidence through surveillance footage at the sites, car rental and flight logs, and a 2012 YouTube video in which a figure resembling Dr. Kanayama spoke about anointing shrines with oil for religious purposes. Officials at the temple and shrine reported that the oily substance left visible and lingering stains on the wooden structures.

Dr. Kanayama’s legal team has argued that the criminal proceedings and extradition were influenced by his Christian faith, raising concerns about potential religious discrimination. However, the Japanese consulate in New York maintained that the extradition stemmed purely from legal considerations and was not motivated by political or religious factors.

It remains unclear whether Dr. Kanayama will return to the United States following the sentencing. His attorney did not respond to requests for comment.