Dice the onion and mushrooms. Grate the Pecorino Romano cheese. Mince the garlic.
Bring a large pot of water to boil, then add 1 tsp of kosher salt to the water.
1 tsp Kosher salt
Heat olive oil in a large skillet over medium-high heat. Add the Italian sausage, breaking it into pieces. Cook until browned on one side, then stir and continue cooking until no pink remains.
1/4 cup Olive Oil, 1 lb Mild Italian Sausage
Add the diced mushrooms to the skillet and cook for about 5 minutes. Reduce heat to medium, add the onions, and cook until softened, about 4-5 minutes. Add the garlic and cook for another minute.
8 oz Baby Bella Mushrooms, 1/2 Onion, 2 cloves Garlic
Add pasta to boiling water and cook until almost al dente.
1 lb Pasta
Meanwhile, pour the white wine into the skillet to deglaze, scraping up any browned bits from the bottom. Reduce the heat to medium and let the wine reduce by half.
1/2 cup White Wine
Stir in the heavy cream and nutmeg, bringing to a low simmer. Simmer gently to thicken slightly.
1 1/2 cup Heavy Cream, 1/8 tsp Nutmeg
Add the almost al dente pasta to the skillet, mixing well to combine with the sauce. Gradually add reserved pasta water as needed to loosen the sauce.
1 cup Pasta Water
Cook, stirring, until the pasta is fully al dente and the sauce coats the pasta nicely.
Remove from heat. Stir in the Pecorino Romano cheese, reserving some for garnish. Season with salt and pepper to taste.
1 cup Pecorino Romano Cheese, Kosher Salt, Black Pepper
Garnish with the remaining cheese and chopped parsley before serving.
Parsley