Thermal integrity profiling (TIP) is a nondestructive testing technique that takes advantage of the concrete heat of hydration (HoH) to detect inclusions during the casting process. This method is becoming more popular due to its ease of application, as it can be used to predict defects in most concrete foundation structures requiring only the monitoring of temperatures. Despite its advantages, challenges remain with regard to data interpretation and analysis, as temperature is only known at discrete points within a given cross-section. This study introduces a novel method for the interpretation of TIP readings using neural networks. Training data are obtained through numerical finite element simulation spanning an extensive range of soil, concrete, and geometrical parameters. The developed algorithm first classifies concrete piles, establishing the presence or absence of defects. This is followed by a regression algorithm that predicts the defect size and its location within the cross-section. In addition, the regression model provides reliable estimates for the reinforcement cage misalignment and concrete hydration parameters. To make these predictions, the proposed methodology only requires temperature data in the form standard in TIP, so it can be seamlessly incorporated within the TIP workflows. This work demonstrates the applicability and robustness of machine learning algorithms in enhancing nondestructive TIP testing of concrete foundations, thereby improving the safety and efficiency of civil engineering projects.