Bring a large pot of salted water to a rolling boil. Add potato gnocchi and cook until they float, about 2-3 minutes. Remove with a slotted spoon and set aside.

In a large skillet, heat olive oil over medium-high heat. Add the Italian sausage and sauté until browned, about 5-7 minutes. Remove and set aside.

Lower heat and add minced garlic to the skillet. Stir for about 1 minute until fragrant, being careful not to brown it.

Mix in pumpkin puree, heavy cream, Parmesan cheese, nutmeg, salt, and pepper. Stir for 3-4 minutes until smooth and thickened.

Gently fold the cooked gnocchi and spinach into the sauce, cooking for 2-3 minutes until spinach is wilted.

Return the cooked sausage to the skillet and stir well for 2 minutes until everything is warmed through.

Spoon onto serving plates and garnish with parsley or basil if desired. Serve warm.