In a saucepan, warm the milk and sugar over medium heat until sugar dissolves. Do not boil.
In a separate bowl, blend softened cream cheese with some of the warm milk mixture until smooth.
Combine the cream cheese mixture with the rest of the milk and add heavy cream, vanilla, and a pinch of salt. Mix well.
Stir in ground pistachio paste and chopped pistachios.
Add 3–4 drops of rose water, stir, and taste. Adjust as needed.
Strain the mixture through a fine-mesh sieve to ensure a smooth base.
Chill the base for at least 4 hours or overnight.
Churn in an ice cream maker according to manufacturer’s instructions.
Transfer to a freezer-safe container, cover with plastic wrap pressed to the surface, and freeze for 4–6 hours or until firm.
Let soften for 10–15 minutes before serving. Garnish with chopped pistachios, dried rose petals, or graham cracker crumbs if desired.