Preheat oven to 375 degrees F (190 degrees C)

Cook your pasta accoding to pasta box instructions, usually 6-8 minutes). Boil water in a large pot, add your salt. Cook pasta until it is slightly al dente as it will continue to cook in cheese sauce the oven when you bake it. Strain it and set aside while you make your pumpkin sage cheese sauce.

Melt half of your butter in a large pot (reuse the one you made your pasta in - less dishes and it's the perfect size) on low heat. Add in your cream and flour, mix well until it's smooth and creamy. Add in your spices and mix until they are well incorporated. Take off of the heat.

Add in your cheese, and mix continuously while the cheese melts. Once your cheese is completely melted, add in your pumpkin puree. 

Add your pasta into your pot to combine with your cheese sauce. 

Transfer your cheesy macaroni into a large 3 quart casserole dish.

Make your bread crumb topping: place your bread crumbs in a microwave safe bowl and adding in the remaining half of your butter. Microwave on medium for 30 seconds to allow the butter to melt. Mix well, and then crumble topping all over the top of your Mac and cheese.

If you want to garnish your pumpkin sage Mac and cheese with some fresh sage, bake for 25 minutes - remove from oven, add some fresh sage on top, and brush with melted butter. Bake for an additional 10 minutes.

If you prefer to omit the sage, just bake for 35 minutes.