Cook macaroni according to package directions, omitting salt and fat. Drain and set aside.
Cook turkey sausage and next 5 ingredients in a large nonstick skillet over medium-high heat until sausage is browned, stirring until it crumbles. Add cooked macaroni, tomato sauce, Italian seasoning, and salt; stir well.
Combine cottage cheese and next 3 ingredients. Spoon half of turkey mixture into a 13- x 9- x 2-inch baking dish coated with cooking spray. Spread cheese mixture over turkey mixture. Top with remaining turkey mixture. Cover and bake at 350° for 40 minutes; uncover and top with Cheddar cheese. Bake 5 additional minutes or until cheese melts.