Hi Amanda, I sent you an e-mail on this as well, but yes you would need to setup the Custom Object for Lead Score.
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You're correct - you only need to recreate the fields (of those MLM fields) that you want to have available to you in SFDC on a page layout. If you just want to see it in Sales Insight, it does not need to be recreated. However, if you just want the one field (Lead Score), you may as well recreate it in SFDC so you could add to a layout in the future if you want. It's not a lengthy process.