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Prepare the zucchini noodles:
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Spiralize zucchini using the ribbon blade or a vegetable peeler; set aside. Pat dry with a paper towel. (This step can be done up to 3 days in advance. Simply store zoodles in an airtight container with a paper towel to help absorb excess moisture.)
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Heat the olive oil in a large skillet over medium-high heat, add in the ground meat and cook until browned, about 3-4 minutes, making sure to crumble and break down into small pieces as it cooks; drain excess fat.
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Add the garlic and saute for 30 seconds to a minute or until fragrant. Add mushrooms and optional chopped zucchini, if using and saute for 4 minutes. Season with salt and pepper to taste. Add tomato paste, diced tomatoes, tomato sauce, oregano, red pepper flakes and 1 tablespoon of basil. Bring to a boil and reduce heat allowing to simmer. Stir constantly until sauce begins to thicken (about 5 minutes).
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Add the ribboned zucchini noodles and cover with lid.
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After 2 minutes, remove cover, swirl the zucchini around using tongs to avoid sticking to the pan.
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Continue cooking until zucchini is tender (another 2-5 minutes). If adding spinach, stir in after 3 minutes and cover.
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Remove from heat and stir in mozzarella and cottage cheese. Taste and adjust seasonings as needed.
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Top with dollops of ricotta cheese. Cover with pan and allow to sit for 2-3 minutes or until the cheese has melted.
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Add water as needed if the sauce is evaporating.