Cook pasta according to the manufacturer's instructions. While the pasta is cooking, make the creamy parmesan sauce:
Over medium heat, add a teaspoon of oil to the non-stick pan and toast the pecans until just fragrant and golden brown, stirring occasionally, careful not to burn (3–4 minutes). Remove and set aside.
Add butter or oil to the pan and sauté the sliced mushrooms until golden brown. (6-8 minutes). Remove and set aside.
Add a little more oil to the pan and sauté the onions over medium-low heat until translucent, 5–6 minutes.
Add minced garlic, sauté until fragrant (1 minute), and add wine. Increase the heat to medium and allow it to simmer for 5 minutes.
Reduce the heat to medium-low, add sage, cream, salt and pepper. Allow to simmer and reduce for 5 minutes, stirring occasionally.
Stir in the parmesan and cream cheese. Simmer and stir for another 1-2 minutes or until the cream cheese is melted into the sauce.
Stir in the spinach and cooked mushrooms and cook for 1 minute until the spinach just starts to wilt.
Add the drained pasta to the sauté pan, stir to combine everything well, and cook another 1-2 minutes until warmed through.
Add to a serving dish, if desired, and top with toasted pecans, parmesan cheese, and fresh sage leaves.