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Bring a large pot of salted water to a boil. Add the cheese tortellini and cook according to package instructions (usually 3–5 minutes). Drain and set aside.
Heat the olive oil in a large skillet over medium heat. Add the garlic and sauté for about 30 seconds until fragrant. Add zucchini and bell peppers and cook for 5–7 minutes until tender-crisp.
Toss in the cherry tomatoes and spinach. Cook for 2–3 more minutes until the tomatoes start to burst and the spinach wilts.
Season the vegetables with oregano, red pepper flakes, salt, and black pepper. Add the drained tortellini and gently toss to combine everything.
Drizzle in lemon juice, sprinkle with fresh basil and Parmesan if using. Taste and adjust seasoning. If the mixture looks a bit dry, add a splash of the reserved pasta water.