1
Cook pasta according to package directions.
2
Meanwhile, in a large nonstick skillet, cook turkey over medium heat until no longer pink; drain. Transfer to a large bowl. Add the 29-ounce can tomato sauce, 1 cup mozzarella cheese, mushrooms, spinach, cottage cheese, Italian seasoning, garlic, garlic powder, pepper flakes and pepper. Drain pasta; fold into turkey mixture.
3
Transfer to a 13-in-9in baking dish coated with cooking spray. combine the water and remaining tomato sauce; pour over pasta mixture. Sprinkle with parmesan cheese and remaining mozzarella cheese. Top with pepperoni.
4
Cover and bake at 350 for 25-30 minutes or until bubbly. Uncover; bake 5 minutes longer or until cheese is melted.