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Preheat oven to 425°F. Toss the butternut squash with olive oil, salt and pepper. Roast for 25–30 minutes, until very tender and lightly caramelized.
Meanwhile, cook pasta until al dente. Before draining, reserve about ½ cup pasta water.
Add the roasted squash to a blender with the cottage cheese, milk, garlic, Dijon, cinnamon and onion powder. Blend until completely smooth and creamy.
Pour the sauce into a large skillet over medium-low heat. Add the cooked pasta and toss until well coated.
Add reserved pasta water a little at a time as needed to thin the sauce and get it super creamy.
Add the Parmesan at the end and stir until melted and incorporated. Season with additional salt and black pepper to taste.
Plate and top with fresh sage and a little extra Parmesan if you want.