Bring a pot of water to a boil and cook the pasta according to package directions. Drain.
Meanwhile, in a skillet over medium-low to medium heat, add the heavy cream and sage leaves. Simmer the cream for 2-3 minutes to thicken. Whisk in the pumpkin puree. Add the five-spice powder and season with salt and pepper to taste. Add the ravioli and stir to coat with the cream sauce. Garnish with sage and serve.