Heat olive oil in a large skillet or braiser over medium heat. Add the sausage and cook, breaking it into chunks, until browned (about 7-8 minutes).
Stir in the onion and garlic and cook for 3-4 minutes, until softened. Add tomato paste, Italian seasoning, and red pepper flakes. Cook 1-2 minutes to deepen the flavor.
Pour in coconut milk, chicken broth, and fire-roasted tomatoes. Stir to combine and bring to a gentle simmer.
Add gnocchi and cook uncovered for 3-4 minutes, until just tender.
Stir in spinach or kale and cook 2-3 minutes until wilted.
Season to taste with salt and pepper. Serve warm, topped with fresh herbs if desired.
