Preheat the oven to 400°F. Roast the diced butternut squash for 25-30 minutes or until tender.

Cook the pasta in salted boiling water until al dente. Reserve 1 cup of pasta water, then drain.

In a large skillet, sauté the sausage over medium heat until browned, breaking it apart as it cooks. Remove and set aside.

In the same skillet, melt butter, then sauté shallots and garlic until fragrant and golden.

Add the roasted butternut squash to the skillet, mash slightly, and stir in sage, salt, and pepper.

Add cooked sausage and spinach to the skillet, cook until spinach wilts, then stir in the Parmesan cheese.

Mix in the cooked pasta, adding reserved pasta water to loosen the sauce as needed. Toss until well coated.

Serve hot, garnished with additional Parmesan if desired.