Thanks for the thoughts Hypsis and JDHill. Here's a clearer example of what I'm seeing:
On the left is the first render of the day, after opening a rhino file saved the previous day. On the right is how it should be. (Ignore the casket, I changed materials on that between renders). The floor and wall are boxes drawn in Rhino (using the Box command), the floor has this material:
Both materials using Channel 0, applied to rhino-drawn objects with Default Texture Mapping. (Rhino's Default mapping radio button checked in Texture Mapping section of Properties panel).
After I noticed it was rendering incorrectly, I stopped the render and opened the material in the plugin Material Editor by double-clicking the material in the list of materials in the Scene Manager. (where you see the screenshot above). Just clicking on any of the tiny previews (to the right of the checkbox, red-circled in screenshot below) seems to remind rhino/maxwell that the object has a size and that real scale is in effect and voila, the preview (in the Rhino rendered preview viewport) snaps to the correct material sizes, and the subsequent Maxwell rendering is correct.
What I seem to be finding, is that Real Scale textures *do* work the way you'd expect them to, except when Rhino or whatever "forgets" the size or orientation of the texture mapping.
It's puzzling, because it doesn't appear to be happening with every object in my scenes, just some objects. There are a bunch of little wood tiles on the lid of the casket, these never seem to lose their scale. The floor though, is almost always f'ed up when I reopen the file.
Everything was drawn in Rhino, nothing imported.