Bring a large pot of salted water to boil. Cook pasta according to package directions until al dente (usually 8-10 minutes). Reserve 1/2 cup pasta water before draining.
While pasta cooks, heat olive oil in a large skillet over medium-high heat. Add sliced sausage and cook for 3-4 minutes until browned on both sides.
Add diced onion and bell pepper to the skillet. Cook for 4-5 minutes until vegetables are softened and onion is translucent.
Add minced garlic, Cajun seasoning, smoked paprika, garlic powder, and cayenne (if using). Stir constantly for 30 seconds until fragrant.
Pour in vegetable broth and coconut cream. Bring to a gentle simmer and cook for 3-4 minutes, stirring occasionally, until sauce begins to thicken slightly.
Add the drained pasta to the skillet. Toss everything together for 2-3 minutes until pasta is well coated. If sauce seems too thick, add reserved pasta water 2 tablespoons at a time until desired consistency is reached.
Season with salt and black pepper to taste. Remove from heat and garnish with fresh parsley and grated Parmesan cheese if desired.
Serve immediately while hot. The sauce should coat the pasta without being too thin or too thick.