Cook pasta: Bring a large pot of salted water to a boil. Add pasta and cook until al dente, about 8–10 minutes. Drain and set aside, reserving a cup of pasta water if needed.

Sauté garlic: In a large skillet, heat olive oil over medium heat. Add minced garlic and sauté for 1–2 minutes until fragrant.

Add pumpkin: Stir in pumpkin puree, onion powder, and dried sage. Cook for 3–4 minutes, stirring occasionally.

Incorporate cream: Slowly pour in heavy cream, stirring continuously until heated through.

Add cheese: Gradually add grated Parmesan cheese, stirring until melted. Season with salt and pepper.

Combine pasta: Toss cooked pasta into the sauce, ensuring it is well coated. Adjust consistency with reserved pasta water as needed.

Serve: Garnish with chopped parsley and serve immediately.