Heat olive oil in a large skillet over medium-high heat. Season the chicken with salt, pepper, Italian seasoning and crushed red pepper (if using) then add to the pan. Cook for about 5–6 minutes, until golden brown and cooked through. Remove the chicken from the skillet and set aside.
In the same pan, add a touch more oil if needed, then add the minced garlic. Sauté for about 30 seconds until fragrant. Add the orzo and cook for 1–2 minutes, stirring often, until lightly toasted.
Pour in the chicken broth and bring to a simmer. Lower the heat, cover, and cook for 8–10 minutes, stirring occasionally, until the orzo is tender and most of the liquid has been absorbed.
Stir in the cream cheese, pesto, and Parmesan until smooth and creamy.
Gently fold in the spinach and cooked chicken. Stir until the spinach wilts and everything is coated in that creamy, flavorful sauce.
Taste and season with salt, pepper, and a squeeze of lemon juice and lemon zest, if you like a little brightness. Top with extra Parmesan before serving!