2 ounces Pecorino Romano cheese (1 cup firmly packed freshly grated or 2/3 cup store-bought grated), plus more for serving
12 ounces ground pork
2 teaspoons kosher salt, divided, plus more as needed
1 teaspoon freshly ground black pepper, divided, plus more as needed
1/2 teaspoon freshly grated or ground nutmeg, divided
1 pound dried short pasta, such as penne, (mezzi) rigatoni, or cavatappi
2 tablespoons olive oil
1/2 cup dry white wine
1 cup heavy cream
Directions:
Bring a large pot of heavily salted water to a boil over medium-high heat. Meanwhile, thinly slice 8 ounces cremini mushrooms (about 4 cups). Finely chop 1 medium shallot (about 1/4 cup). Mince 4 garlic cloves. Pick the leaves from 1 fresh rosemary sprig and finely chop until you have 3/4 teaspoon. Finely grate 2 ounces Pecorino Romano cheese (about 1 cup), or measure 2/3 cup store-bought grated.
Place the rosemary, 3/4 of the minced garlic, 12 ounces ground pork, 1 1/2 teaspoons of the kosher salt, 3/4 teaspoon of the black pepper, and 1/4 teaspoon of the ground nutmeg in a medium bowl. Mix with your hands until thoroughly combined. Keeping the sausage mixture in the bowl, shape it into a flat, round patty that’s about 1/2-inch thick.
Add 1 pound dried short pasta to the boiling water and cook according to package directions until al dente.
Meanwhile, heat 2 tablespoons olive oil in a large, high-sided sauté pan or Dutch oven over medium-high heat until shimmering. Add the sausage patty and cook undisturbed until the bottom is golden-brown, about 4 minutes. Flip the patty and, using a wooden spoon, break it up into 1/2-inch pieces.
Add the mushrooms and cook until sausage is just cooked through and the mushrooms are softened, 2 to 3 minutes. Add the shallot and remaining minced garlic and cook until softened, 1 to 2 minutes.
Add 1/2 cup dry white wine and bring to a simmer. Cook, scraping up any browned bits from the bottom of the pan with a wooden spoon, until the wine is reduced by about half, about 1 minute. Add 1 cup heavy cream, the remaining 1/2 teaspoon kosher salt, 1/4 teaspoon black pepper, and 1/4 teaspoon ground nutmeg. Bring to a simmer and cook until thickened slightly, 2 to 3 minutes. Turn off the heat, add the cheese, and stir to combine.
When the pasta is ready, reserve 1/2 cup of the pasta water, then drain the pasta. Return the pan of sauce to medium-high heat. Add the pasta and toss to coat, adding the reserved pasta water a little at a time as needed to get a saucy consistency. Taste and season with more kosher salt and black pepper as needed. Garnish with more grated Pecorino Romano if desired.