In a large pot of boiling salted water, cook the gnocchi according to package instructions until they float to the surface. This usually takes about 2-3 minutes. Drain and reserve.
In a large skillet over medium heat, heat the olive oil. Add the halved cherry tomatoes and cook for about 3-4 minutes until they start to soften. Add the baby spinach and cook until wilted, about 1-2 minutes.
Reduce the heat to low and add the heavy cream to the skillet, stirring well to combine. Gradually stir in the pesto and mix until the sauce is well blended.
Add the cooked gnocchi to the skillet, stirring gently to coat them with the creamy pesto sauce. Allow to simmer for 2-3 minutes to heat through.
Stir in the grated Parmesan cheese, and season the dish with salt, pepper, and red pepper flakes if using. Mix well until the cheese melts and everything is evenly combined.
Divide the creamy pesto gnocchi onto plates and garnish with extra Parmesan cheese if desired.