Bring a large pot of heavily salted water to a rolling boil. Add the potato gnocchi and cook according to package instructions, typically 2-3 minutes until they float. Drain and set aside.

In a large skillet, heat olive oil over medium-high heat. Add the Italian sausage, breaking it into crumbles. Cook for about 5-7 minutes until browned. Transfer to a plate, leaving drippings in the skillet.

In the same skillet, reduce heat to medium and add minced garlic. Sauté for about 1 minute until fragrant and lightly golden.

Lower heat to medium-low and add pumpkin puree and heavy cream. Stir in grated Parmesan, nutmeg, salt, and pepper, and simmer for about 2-3 minutes until smooth.

Add the cooked gnocchi to the skillet and toss to coat. Then, add fresh spinach, stirring until wilted, about 1-2 minutes.

Return the browned sausage to the skillet, stir to combine and heat through for another 2 minutes.

Remove from heat and serve the creamy pumpkin gnocchi immediately, garnished with parsley or basil.