I was thinking the same. It could be a very obscure Gelugpa lineage but the combination of those figures and others (e.g. a two-armed Kurukulle, one of the four heavenly kings, a green Tara, etc.) seems odd and doesn't fit with my recollection of that particular Mahakala.
It could of course just be a thangka for personal practice that someone has commissioned with a lot of their personal practices on it. I know a few lamas who have such thangkas and indeed I've commissioned one like that for myself before.
Is there a source/age for the image in question? That would help a lot