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Cook the Italian sausage in a large pot or dutch oven over medium-high heat until browned and cooked through, about 5-7 minutes, making sure to crumble the sausage as it cooks.
Add the diced onion and minced garlic to the pot and cook for 2-3 minutes until fragrant.
Pour in the chicken broth and heavy cream and stir to combine.
Add the Parmesan cheese, salt, pepper, Italian seasoning, oregano, parsley, garlic powder, onion powder, and crushed red pepper. Stir to combine.
Add the gnocchi and tomato paste and stir to incorporate.
Bring the soup to a simmer and cook for 5-7 minutes, until the gnocchi is tender.
Add the spinach and cook for 2-3 minutes until wilted.
Serve hot and enjoy!