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In a large skillet with a cover, combine pizza sauce, diced tomatoes, water, and pepperoni. Place Meatballs in oven to cook while preparing pasta.
Over high heat, bring to a boil, add pasta, reduce heat to medium or medium-high (low boil), and cover. Cook covered for 8-10 minutes (using pasta directions as a guide) or until al dente, stirring occasionally to make sure all pasta gets cooked evenly.
In the last 1-2 minutes of cooking, add spinach and cover. When wilted, stir into pasta.
Reduce heat to low and stir in shredded cheese, until melted. Halve meatballs and add to pasta, stirring to mix.
If desired, add extra cheese and pepperoni to top and broil under high heat until bubbling and golden brown.
Garnish if desired with fresh parsley or basil.