Cook pasta according to package instructions until al dente. Drain and set aside.
In a large skillet, heat olive oil over medium heat. Add sausage and cook until browned, breaking it up with a spoon.
Add minced garlic, red pepper flakes, and smoked paprika. Sauté for 1 minute.
Stir in mashed butternut squash, chicken broth, and heavy cream. Simmer for 5-7 minutes until creamy.
Add Parmesan cheese and stir until melted and incorporated.
Toss in fresh spinach and cooked pasta. Stir until spinach wilts and everything is coated evenly.
Season with salt and pepper to taste. Serve warm with extra Parmesan if desired.