In a large pot of salted boiling water, cook your pasta according to the package instructions. Reserve 1/4 cup of pasta water, then drain and set aside.

Heat olive oil or butter in a medium saucepan over medium heat.

Add minced garlic and sauté until fragrant, about 1 minute.

Stir in pumpkin puree, mixing well to combine with the garlic. Cook for 2 minutes to enhance the pumpkin flavor.

Lower the heat and stir in the heavy cream. Add nutmeg, sage, paprika (if using), salt, and pepper. Simmer gently for 5 minutes.

Stir in the grated Parmesan cheese until melted and the sauce becomes creamy. If the sauce is too thick, add broth or reserved pasta water a tablespoon at a time until the desired consistency is reached.

Add the cooked pasta to the sauce, tossing to coat evenly. Cook for another 1-2 minutes to warm through.

Serve hot, garnished with additional Parmesan and chopped parsley.