In a large skillet coated with cooking spray, brown sausage and break into chunks. Set aside and wipe down skillet.
Coat skillet with cooking spray again. Over medium heat, cook garlic until fragrant, about 30 seconds. Add in mushrooms and saute until browned and slightly soft, about 5 minutes. Season with salt, pepper, and pepper flakes.
Add in wine and simmer until nearly evaporated, about 5 minutes, then add in cooked sausage.
Whisk half and half, almond milk, and cornstarch in a large measuring cup. Add into the skillet and simmer until slightly thickened, about 5 minutes.
Take skillet off heat and slowly stir in parmesan cheese until melted. Add cooked pasta to the skillet and return to low-medium heat. Toss everything together and cook until for a few minutes until the pasta soaks up most of the sauce.