As Machine Learning (ML), Artificial Intelligence (AI), and Large Language Models (LLMs) evolve toward increasingly autonomous systems, the integrity, governance, and trustworthiness of data have become decisive factors in determining real-world effectiveness. Traditional data governance approaches-largely manual, reactive, and compliance-driven-are insufficient to support the scale, velocity, and heterogeneity of modern intelligent systems. In regulated domains such as healthcare, these limitations manifest as model hallucination, bias amplification, regulatory non-compliance, and escalating technical debt.This paper proposes a governance-by-design framework that synergistically integrates ML, AI, and LLMs to enable scalable, proactive, and explainable data governance. ML automates data profiling, quality assessment, and bias detection; AI enables predictive stewardship through risk forecasting, anomaly detection, and autonomous policy enforcement; and LLMs provide semantic governance by interpreting unstructured data and regulatory text in natural language. The framework is validated through a longitudinal health informatics case study focused on di
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