01 - Heat olive oil in a large soup pot or Dutch oven over medium heat. Add the Italian sausage, breaking it apart with a wooden spoon, and cook until thoroughly browned. Transfer the sausage to a plate using a slotted spoon, leaving the rendered fat in the pot.
02 - Add the diced onion, sliced carrots, and celery to the pot. Cook for 5 minutes, stirring occasionally, until the vegetables have softened. Add the minced garlic and cook for an additional minute until fragrant.
03 - Stir in the cubed butternut squash, dried thyme, ground nutmeg, and half of the chopped fresh sage. Season with salt and pepper to taste, then sauté for 2 to 3 minutes to allow the flavors to meld.
04 - Pour in the chicken broth and bring to a boil. Reduce the heat to a simmer, cover the pot, and cook for 20 minutes until the butternut squash is fork-tender.
05 - Use an immersion blender to purée part or all of the soup for a creamy base. Leave some chunks intact if you prefer a heartier, rustic texture.
06 - Return the browned sausage to the pot. Stir in the cheese tortellini and simmer uncovered for 6 to 8 minutes until the tortellini is cooked through and tender.
07 - Stir in the heavy cream and the remaining chopped sage. Heat gently without boiling. Taste and adjust the seasoning with additional salt and pepper as needed, then remove from heat.
08 - In a mixing bowl, combine the softened cream cheese, ricotta cheese, finely chopped sage, milk, and a pinch of salt and pepper. Blend until completely smooth and creamy.
09 - Ladle the hot soup into serving bowls. Add a generous spoonful of the sage cheese mixture to each bowl and swirl gently with a spoon or knife. Garnish with extra fresh sage or cracked pepper and serve immediately.