Bring 1 pot of salted water to a boil and cook CAULIPOWER Cauliflower Linguine according to package instructions. Reserve 1 cup of the pasta water, drain pasta, and set aside.
Melt the butter in a large saucepan over medium heat, then add the flour and whisk constantly until it turns a golden color and smells nutty. Add the garlic and cook for 30 seconds then slowly pour in the milk, whisking constantly to smooth any clumps.
Increase the heat to medium high, stirring constantly, until the sauce bubbles and thickens, about 8 to 10 minutes. Remove the pan from the heat, then stir in the pumpkin, cream cheese, half of the chopped sage leaves, salt, pepper, cinnamon, nutmeg, and cayenne.
Continue whisking until the cream cheese melts and the sauce is smooth. Add additional salt and pepper as desired.
Add the cooked pasta to the pan and gently toss to combine. Thin the pasta with a bit of the reserved pasta water as needed if it seems too thick or sticky. Serve immediately, topped with parmesan and the remaining sage.