In a medium pot, bring water to boil. Add pasta, cook using package instructions. When pasta is done, drain water and set aside.
In a separate large pot, melt butter under medium heat. Add onions and carrots. Sauté until tender, about 1-2 minutes. Add garlic, sauté for another 30 seconds.
Add pumpkin puree, tomato puree and chicken broth. Stir to combine. Add sage leaves, bring to a boil. Cook for 2-3 minutes, stir continuously.
Optional: Using an immersion blender, blend sauce.
Add half and half. Stir to combine. Bring to a boil, then add salt.
Bring cooked pasta into the sauce. Toss to combine.
Garnish with parmesan cheese. Serve and enjoy!