Begin by bringing a large pot of salted water to a rolling boil. Once boiling, add high-protein pasta, cooking according to package instructions for 8-10 minutes. Reserve ½ cup of pasta water before draining.

In a blender, combine cottage cheese, tomato sauce, and fresh basil. Blend on high speed until smooth, about 30 seconds. Adjust with a tablespoon of water if needed.

Heat olive oil in a skillet over medium heat. Add finely chopped onion and sauté for 2-3 minutes until translucent. Stir in minced garlic and cook for an additional minute.

Add the lean turkey sausage to the skillet, breaking it into smaller pieces. Cook for 5-6 minutes until browned and cooked through.

Reduce heat to low and pour the cottage cheese sauce into the skillet. Stir well and allow flavors to meld for about 2 minutes. Add drained pasta and mix thoroughly, adjusting consistency with reserved pasta water if necessary. Serve hot, garnished with parmesan and additional basil.