Bring a large pot of salted water to a boil. Add the Mountain High Organics elbow pasta and cook according to the package instructions until al dente. Save some of the pasta cooking water, drain the pasta, and set aside.

In a large pan, heat the olive oil over medium heat. Add the minced garlic, fresh sage, and red pepper flakes, sautéing until fragrant, about 1-2 minutes.

Stir in the pumpkin puree, coconut milk, nutritional yeast, and ground nutmeg. Cook for about 5 minutes, stirring frequently until the sauce is heated through and well combined.

Add the cooked pasta to the pan with the sauce. Toss to coat the pasta evenly, ensuring each piece is well covered with the pumpkin mixture. Add some pasta water, a little at a time, if needed to thin the sauce out. Season with salt and pepper to taste.

Garnish with extra chopped sage and pumpkin seeds and serve warm.