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Senanayake who is the Medical Director at Suwasevana was educated at the University of Peradeniya. He trained at the Professorial medical unit at General Hospital Colombo, working alongside HHR Samarasinghe and Kumaradasa Rajasuriya. After training in the UK and obtaining his MRCP he was appointed Senior Lecturer in Medicine. He was subsequently promoted to Professor of Medicine and Dean of the Faculty of Medicine at the University of Peradeniya. Senanayake has served as Chairman of Board of Study in Medicine at the Postgraduate Institute of Medicine, President of the Sri Lanka Medical Association and President of the Kandy Society of Medicine