Piendibene made his debut for the Uruguay national football team in 1909 against Argentina in Buenos Aires. Over the course of his 14 year career with the national team he was capped 40 times, scoring 20 goals. He made his final appearance for La Celeste in November 1923.
At the 1916 South American Championship Piendibene scored the first goal of the tournament in a match against Chile. He finished the tournament with two goals and was equal second place in the goalscorers list.