show me the domain conf
Le_RealCertPath=''
Le_RealCACertPath=''
Le_RealKeyPath='/etc/nginx/acme.sh/psychiatr.ru/key.pem'
Le_ReloadCmd='__ACME_BASE64__START_c2VydmljZSBuZ2lueCBmb3JjZS1yZWxvYWQ=_ACME_BASE64__END'
Le_RealFullChainPath='/etc/nginx/acme.sh/psychiatr.ru/cert.pem'
Le_Domain='psychiatr.ru'
Le_Alt='*.psychiatr.ru'
Le_Webroot='dns'
Le_PreHook=''
Le_PostHook=''
Le_RenewHook=''
Le_Keylength=''
Le_OrderFinalize='https://acme-v02.api.letsencrypt.org/acme/finalize/32843959/553861181'
Le_Vlist='psychiatr.ru#Jr7iHNy2s9qJBgGpS6b7d3w7tnLOGAtf_NxEgIT2gLw.HG7BdQYFIW1jOSnH7pAv7QQQaac_Cr3L7prdQABp2Zc#https://acme-v02.api.letsencrypt.org/acme/challenge/2px-J7_g_qGtSv8pdqoGFSZNZypITh8IBYt58RDkEoE/17029271759#dns-01#dns,*.psychiatr.ru#rt72l2QajT4iziT0KDq2UFbT0_YtzaMvWB2S0Uoi2vQ.HG7BdQYFIW1jOSnH7pAv7QQQaac_Cr3L7prdQABp2Zc#https://acme-v02.api.letsencrypt.org/acme/challenge/MGQZyFr6DnexGNfnDI8VvDf_2b-ZrDoB_l1j6HQq320/17029271754#dns-01#dns,'
it seems that he is using dns manual mode.
Yes, you are right: --yes-I-know-dns-manual-mode-enough-go-ahead-please
Perhaps try to create a new Letsencrypt account.
You mean acme.sh --deactivate-account option?