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Ivey was born in Atlanta, Georgia, the daughter of Mary Nell Ivey Santacroce, a teacher, speech therapist and actress who appeared in productions of Driving Miss Daisy and taught at Georgia State University, and Hugh Daugherty Ivey, a physicist and professor who taught at Georgia Tech and later worked at the Atomic Energy Commission. Her parents later divorced. She has a younger brother, John, and a half-brother, Eric Santacroce, from her mother's re-marriage to Dante Santacroce. Ivey has described her Unitarian upbringing as "very liberal." She received her undergraduate degree at Rollins College in Winter Park, Florida, and then received a Fulbright grant to study drama at the London Academy of Music and Dramatic Art. She was a member of the Phi Mu sorority at Rollins College. She received an Honorary Doctorate (Humane Letters) from Rollins College in February 2008.

Ivey appeared in numerous American and Canadian stage productions before making New York City her home in the late 1970s. She made her Broadway debut playing two small roles in a 1981 production of Macbeth; the following year she was cast in a major supporting role in a revival of Noel Coward's Present Laughter, for which she received the Clarence Derwent Award as Outstanding Featured Actress in a Play. She was nominated for two Tony Awards in the same season (1984) - as Best Featured Actress in a Musical for Stephen Sondheim's Sunday in the Park with George and Best Featured Actress in a Play for a revival of George Bernard Shaw's Heartbreak House - a feat repeated by only two other actresses, Amanda Plummer and Kate Burton. Ivey's performances in Driving Miss Daisy (in the title role) and Quartermaine's Terms won her Obies, an annual award presented by the newspaper The Village Voice for off-Broadway productions.

Ivey's first major screen appearance was in Steven Spielberg's adaptation of Alice Walker's The Color Purple in 1985. Her many film credits include Dirty Rotten Scoundrels, Sabrina, Postcards from the Edge, The Adventures of Huck Finn, The Scarlet Letter, Home Alone 2: Lost in New York, Sleepless in Seattle, Two Weeks Notice, and Legally Blonde 2: Red, White & Blonde. Most recently, she had a small role in Rush Hour 3 as a nun.

In 1978, Ivey made her television debut in the daytime soap opera Search for Tomorrow. Her television credits include the 1982 miniseries Little Gloria... Happy at Last, and guest appearances on Homicide: Life on the Street, Law & Order, Oz, The Practice, Sex and the City, and Monk. She has also guest starred as the tyrannical President of the Condo board, Ms Langer, in the Three Days of the Condo episode of Frasier.

Ivey was recently seen in the New York premiere of The Savannah Disputation by Evan Smith at the Off-Broadway theater Playwrights Horizons. The comedy co-starrred Marylouise Burke, Reed Birney, and Kellie Overbey and was directed by Walter Bobbie (director of the revival of Chicago). The production ran from February 6, 2009 through March 15.