Preheat your oven to 325°F (160°C).

In a medium saucepan, whisk together pumpkin puree, heavy cream, milk, and sugar. Warm over medium heat, stirring occasionally, until it is heated through but not boiling.

In a separate bowl, whisk the egg yolks thoroughly. Slowly add about half of the warmed pumpkin mixture to the egg yolks while whisking continuously.

Pour the tempered egg mixture back into the saucepan with the remaining pumpkin mixture. Stir in vanilla extract, pumpkin pie spice, and a pinch of salt.

Strain the mixture through a fine mesh sieve to eliminate any lumps.

Divide the custard among small ramekins or pots and place them in a baking dish. Fill the baking dish with warm water until it reaches halfway up the sides of the ramekins.

Bake for 25-30 minutes, or until the edges are set but the centers remain slightly jiggly.

Remove the ramekins from the water bath and let them cool for about 10 minutes. Transfer to the refrigerator to chill for at least 2 hours before serving.