You can extend the initial 60-day entry 30 days at any immigration office for 1900 baht. Then do a border hop for another 60-day entry and repeat. You can even do a border hop on the day before the visa expires and get another 60+30, which means you get nearly 9 months out of the 6-month METV.
No it is not compulsory to do an extension. Border hop with METV at Mae Sai will result in another 60-day entry. Compare w/extension 30 days 1900 baht vs. Mae Sai run from CM by bus (320-638 baht, depending on class) + 500b for the Myanmar border run). So border run is a bit cheaper, but takes a whole day, +60 vs. 30 days.
Technically-speaking it's a bilateral agreement, not a visa exemption, but pretty sure it can be extended same same 30 days (at the discretion of immigration officer, as usual).
Oh so you've already done 2 tourist visas and 2 visa exemptions in the past year? There is never a guarantee that you will get another. Bring proof of 20k Baht (preferably in cash) also for the return to Thailand as border officials are reportedly requiring this even if you have a tourist visa. As for other documents in Penang, just 2 photos and your passport with a couple clean pages + signed photocopies of your main page and Malaysian entry stamp page. And it helps to dress politely ;-)