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This study investigates the programmable strain sensing capability, auxetic behaviour, and failure modes of 3D-printed, self-monitoring auxetic lattices fabricated from in-house engineered polyetheretherketone (PEEK) reinforced with multi-walled carbon nanotubes (MWCNTs). A skeletally-parametrized geometric modelling framework, combining Voronoi tessellation with 2D wallpaper symmetries, is used to systematically explore a vast range of non-predetermined topologies beyond traditional lattice designs. A representative set of these architectures is realized via fused filament fabrication, and multiscale characterization—including macroscale tensile testing and microstructural analysis—demonstrates tuneable multifunctional performance as a function of MWCNT content and unit cell topology. Real-time resistance measurements track deformation, damage initiation, and progression, with the sensitivity factor increasing from below 1 in the elastic regime (strain sensitivity) to as high as 80 for PEEK/MWCNT at 6 wt.% under inelastic deformation (damage sensitivity). Implicit architecture-topology tailoring further allows fine-tuning of mechanical properties, achieving stiffness values ranging from 9 MPa to 63 MPa and negative Poisson’s ratios between –0.63 and –0.17 using ~3 wt.% MWCNT at a relative density of 25%. Furthermore, a novel piezoresistive finite element model, implemented in Abaqus via a user-defined subroutine, accurately captures the electromechanical response up to the onset of ligament failure, offering predictive capability. These results demonstrate how architecture-topology tuning can be leveraged to customise strain sensitivity and failure modes, enabling the development of multifunctional piezoresistive lattice composites for applications such as smart orthopaedic implants, aerospace skins, and impact-tolerant systems.