Learn Italian: La dottoressa è tedesca e parla italiano. - The doctor is German and speaks Italian.

In Italian, many nouns for professions change their ending based on the gender of the person. Since this doctor is a woman, the masculine dottore changes to the feminine dottoressa.

Why aren't tedesca and italiano capitalized like they would be in English?

In Italian, adjectives for nationalities and nouns for languages are not capitalized unless they are at the very beginning of a sentence. So, tedesca (German) and italiano (Italian) are written in lowercase.

Shouldn't italiano be feminine (italiana) to match the female doctor?

No, because here italiano is a noun meaning the Italian language, which is always masculine. If it were an adjective describing the doctor herself (the way tedesca does), it would change to match her gender.

How do I know when to use è with an accent versus e without an accent?

The accent changes the meaning completely! è (with the accent) means is (from the verb essere), while e (without the accent) means and. You can see both used in this exact sentence.