Hi this is a known issue:
Elastic Cloud strips the accept header and NEST wants the cat data in json form.
You can use the lowlevel cat API instead to circumvent the problem
var client = new ElasticClient(new Uri("http://localhost:9200"));
var catHealth = client.LowLevel.CatHealth<string>();
//catHealth.Body will hold the string as returned by default by elasticsearch
or just use the .ClusterHealth() endpoint to get the same information in a more typed fashion
var clusterHealth = client.ClusterHealth();